Z Gastroenterol 2014; 52 - P_4_13
DOI: 10.1055/s-0033-1360966

Early lactate clearance as predictor of initial poor graft function after liver transplantation – a confirmative study

JF Lock 2, AN Kotobi 1, M Stockmann 1
  • 1Charité – Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Berlin, Germany
  • 2University Hospital of Würzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, Würzburg, Germany

Background: Initial graft function determines postoperative survival and morbidity after liver transplantation (LTx). Lactate clearance has been reported as a good marker of liver function in particular in the initial phase after liver transplantation. The aim of this study was to perform a confirmative analysis of the recently published diagnostic power of early lactate clearance (ELC).

Methods: Retrospective analysis of 323 patients receiving LTx. Calculation of ELC according to Wu et al.. Comparison with conventional blood parameters and the incidence of initial poor graft function (IPGF) according to Nanashima et al. Statistical analysis included comparison of means by Mann-Whitney U test and receiver operating characteristic analysis.

Results: Mean ELC was 22.3%. The incidence of IPGF was 16.4%. Patients suffering from IPGF (n = 53) yielded reduced ELC of 12.3 ± 41.8% vs. 24.4 ± 50.1% for those without IPGF (n = 270) (P = 0.003). The AUROC for prediction of IPGF was 0.629 (P = 0.003). There was no difference of patients' survival according the ELC (P = 0.984).

Conclusion: The diagnostic accuracy of ELC to predict IPGF could not be reproduced in this patient sample. Although mean ELC levels are reduced in those patients defined as IPGF, the wide distribution of results does not allow individual prediction of outcome by this parameter.