UNLABELLED: This study was performed to investigate whether intraoperative changes in blood lactate levels after hepatic allograft reperfusion reflect initial graft function in living donor liver transplantation (LDLT). PATIENTS AND METHODS: From 1994 to 2003, 15 of LDLT cases were divided into two groups based on the intraoperative blood lactate levels. Group A consisted of seven recipients whose new liver grafts started to consume lactate immediately after portal perfusion. Group B consisted of the remaining eight recipients whose intraoperative blood lactate values showed no change or an elevation for 2 hours after graft revascularization. RESULTS: All Group A patients survived, whereas three out of eight patients in Group B died of infection and portal vein thrombosis within 3 months after LDLT. There was no significant difference in preoperative donor and recipient laboratory data. The recipient age and body size in Group B were significantly higher than those in Group A, indicating that Group B consisted of small-for-size liver transplant cases. Serum total bilirubin concentrations in Group B were significantly higher than Group A from postoperative day 5 to 23, whereas postoperative liver enzyme levels and prothrombin time were similar between the two groups. CONCLUSION: The change in intraoperative blood lactate after hepatic allograft reperfusion served as an accurate predictor of initial graft function which was associated with graft size in human LDLT.
UNLABELLED: This study was performed to investigate whether intraoperative changes in blood lactate levels after hepatic allograft reperfusion reflect initial graft function in living donor liver transplantation (LDLT). PATIENTS AND METHODS: From 1994 to 2003, 15 of LDLT cases were divided into two groups based on the intraoperative blood lactate levels. Group A consisted of seven recipients whose new liver grafts started to consume lactate immediately after portal perfusion. Group B consisted of the remaining eight recipients whose intraoperative blood lactate values showed no change or an elevation for 2 hours after graft revascularization. RESULTS: All Group A patients survived, whereas three out of eight patients in Group B died of infection and portal vein thrombosis within 3 months after LDLT. There was no significant difference in preoperative donor and recipient laboratory data. The recipient age and body size in Group B were significantly higher than those in Group A, indicating that Group B consisted of small-for-size liver transplant cases. Serum total bilirubin concentrations in Group B were significantly higher than Group A from postoperative day 5 to 23, whereas postoperative liver enzyme levels and prothrombin time were similar between the two groups. CONCLUSION: The change in intraoperative blood lactate after hepatic allograft reperfusion served as an accurate predictor of initial graft function which was associated with graft size in human LDLT.
Authors: Michael J J Chu; Anthony J R Hickey; Sherry Tagaloa; Linda Zhang; Anna J Dare; Julia R MacDonald; Mee-Ling Yeong; Adam S J R Bartlett; Anthony R J Phillips Journal: PLoS One Date: 2014-06-23 Impact factor: 3.240
Authors: Matthew G Wiggans; Tim Starkie; Golnaz Shahtahmassebi; Tom Woolley; David Birt; Paul Erasmus; Ian Anderson; Matthew J Bowles; Somaiah Aroori; David A Stell Journal: Perioper Med (Lond) Date: 2013-10-07