Peri-operative blood lactate levels in recipients of living-related liver transplantation.
BACKGROUND
The role of changes in peri-operative blood lactate levels in recipients of living-related liver transplants has not yet been clarified.


METHODS
Forty-three recipients were included in this study. Blood lactate, plasma total bilirubin, aminotransferase, body temperature, and gastric mucosal PCO2 levels were measured at six time points during surgery: just before the initiation of surgery, just after dissection of the hepatic vasculature, at the end of the anhepatic phase, and 30, 60, and 120 min after reperfusion. We calculated the rate of lactate accumulation during the pre-anhepatic and anhepatic phases and the elimination rate during reperfusion (neohepatic phase), and examined the correlation between these results and the clinical findings.


RESULTS
The rate of lactate elimination during the neohepatic phase was correlated with the ratio of graft weight to standard liver volume (P<0.0001). There was also a significant correlation between the rate of lactate accumulation during the pre-anhepatic phase and the preoperative total bilirubin levels (P=0.0008).


CONCLUSIONS
Each pre-anhepatic, anhepatic, and neohepatic phase had a characteristic blood lactate profile. The graft size strongly affected lactate levels during the early neohepatic phase.
Orii
R
R
Department of Anesthesiology, Graduate School of Medicine, University of Tokyo, Japan.
Sugawara
Y
Y
Hayashida
M
M
Yamada
Y
Y
Kubota
K
K
Takayama
T
T
Harihara
Y
Y
Makuuchi
M
M
Hanaoka
K
K
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001831:Body Temperature; D002245:Carbon Dioxide / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D005753:Gastric Mucosa / Q000502:physiology; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D007773:Lactates / Q000097:blood*; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period
D007773:Lactates; D002245:Carbon Dioxide; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin