Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
We examined the utility of perioperative lactate values for the prediction of multiple post-transplant outcomes including length of hospital stay (LOS), acute cellular rejection (ACR), and mortality in a single center liver transplant population.
Retrospective chart review of all patients undergoing primary orthotopic liver transplant at a large urban tertiary care center from 2008-2010. Data was obtained on recipient demographics, donor age, donor gender, surgical time points, cold ischemia time (CIT), preoperative lactate, peak intraoperative lactate, and peak postoperative lactate (maximum lactate value within 48 hours post-surgery). We examined outcomes of postoperative LOS, history of moderate or severe ACR, and mortality. Analysis was performed using multivariate linear and logistic regression models.
273 patients were included for analysis. Mean recipient age was 52 (range 17-72) with 66% males. Mean donor age was 43 (range 7-83) with 40% males. Mean CIT was 312 minutes (range 12-699). Mean MELD was 22 (range 6-53). For every one unit increase in peak intraoperative lactate there was a 1.64 day increase in LOS (p < 0.001). For every one unit increase in peak intraoperative lactate the odds of death was significantly increased at one month (OR = 1.37, p = 0.001) and one year (OR = 1.14; p = 0.021). For every one unit increase in peak postoperative lactate there was a 1.76 day increase in LOS (p < 0.001). The odds of death was significantly increased for every one unit increase in peak postoperative lactate at one month (OR = 1.28; p =0.004) and one year (OR = 1.13; p = 0.003). Preoperative lactate was not associated with any significant adverse outcomes. None of the perioperative lactate values were associated with developing an episode of moderate or severe ACR after transplant.
Our results create a better understanding and interpretation of perioperative lactate values in liver transplantation. Findings clearly show an association between perioperative lactate values and mortality up to one year after transplant.
CITATION INFORMATION: Rao B, Yoshida A, Ibrahim M, Jafri S.-M. The Use of Perioperative Lactate Values as Markers for Adverse Outcomes in Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Rao B, Yoshida A, Ibrahim M, Jafri S-M. The Use of Perioperative Lactate Values as Markers for Adverse Outcomes in Liver Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-use-of-perioperative-lactate-values-as-markers-for-adverse-outcomes-in-liver-transplantation/. Accessed October 27, 2020.
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