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

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.