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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2018 Feb 05

DOI: 10.23736/S0375-9393.18.12285-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Usefulness of post-reperfusion lactate clearance for predicting early graft recovery in liver transplant patients: a single centre study

Valter PERILLI 1, Paola ACETO 1 , Teresa SACCO 1, Pierpaolo CIOCCHETTI 1, Domenico PAPANICE 1, Carlo LAI 2, Liliana SOLLAZZI 1

1 Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy; 2 Dynamic and Clinical Psychology Department, Sapienza University of Rome, Rome, Italy


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BACKGROUND: The role of post-reperfusion lactate clearance in assessing graft function has not yet been investigated. The aim of this study was to examine whether lactate clearance, assessed in the post-reperfusion phase, can predict poor graft function in liver transplant patients.
METHODS: Seventy patients undergoing liver transplantation (LT) were enrolled. Standardised anaesthesia and intraoperative monitoring were applied. The lactate level measured immediately after venous reperfusion and 6 hours later were used to calculate lactate clearance by the following formula: [(reperfusion lactate - 6h post-reperfusion lactate)/reperfusion lactate] ×100. Student’s t-test was performed to evaluate differences in lactate clearance between patients with good and poor graft function. Logistic regression was used to assess predictors of poor graft function.
RESULTS: Post-reperfusion lactate clearance was lower in patients with poor graft function compared to those with good graft function (p=0.0007). Logistic regression showed that post-reperfusion lactate clearance may represent an early predictor of poor graft function (area under receiver operating characteristic curve = 0.83). A lactate clearance cut-off of 59.7% was found (90% sensitivity, 38.3% specificity).
CONCLUSIONS: Post-reperfusion lactate clearance may be useful for the early identification of poor graft function after LT. In patients with lactate clearance <59.7%, it could be useful to search for the underlying cause of poor graft function.


KEY WORDS: Liver graft dysfunction - Metabolite - Lactate clearance - Post-reperfusion phase - Liver transplantation

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Publication History

Article first published online: February 5, 2018
Manuscript accepted: January 26, 2018
Manuscript revised: January 22, 2018
Manuscript received: July 4, 2017

Cite this article as

Perilli V, Aceto P, Sacco T, Ciocchetti P, Papanice D, Lai C, et al. Usefulness of post-reperfusion lactate clearance for predicting early graft recovery in liver transplant patients: a single centre study. Minerva Anestesiol 2018 Feb 05. DOI: 10.23736/S0375-9393.18.12285-1

Corresponding author e-mail

pa.aceto@gmail.com