title: The use of perioperative serial blood lactate levels, the APACHE II and the postoperative MELD as predictors of early mortality after liver transplantation.
abstract: To evaluate the accuracy of different parameters in predicting early (one-month) mortality of patients submitted to orthotopic liver transplantation (OLT).
  
  
  
  This is a retrospective study of forty-four patients (38 males and 10 females, mean age of 52.2 ± 8.9 years) admitted to the Intensive Care Unit of a tertiary hospital. Serial lactate blood levels, APACHE II, MELD post-OLT, creatinine, bilirubin and INR parameters were analyzed by receiver-operator characteristic (ROC) curves as evidenced by the area under the curve (AUC). The level of significance was set at 0.05.
  
  
  
  The mortality of OLT patients within one month was 17.3%. Differences in blood lactate levels became statistically significant between survivors and nonsurvivors at the end of the surgery (p<0.05). The AUC was 0.726 (95%CI = 0.593-0.835) for APACHE II (p = 0.02); 0.770 (95%CI = 0.596-0.849) for blood lactate levels (L7-L8) (p = 0.03); 0.814 (95%CI = 0.690-0.904) for MELD post-OLT (p < 0.01); 0.550 (95%CI = 0.414-0.651) for creatinine (p = 0.64); 0.705 (95%CI = 0.571-0.818) for bilirubin (p = 0.05) and 0.774 (95%CI = 0.654-0.873) for INR (p = 0.02).
  
  
  
  Among the studied parameters, MELD post-OLT was more effective in predicting early mortality after OLT.
authors: Division of Intensive Care, Department of Surgery and Anatomy, FMRP, USP, Ribeirao Preto, SP, Brazil. abasile@fmrp.usp.br
authors: Anibal
authors: A
authors: Basile-Filho
authors: Edson Antonio
authors: EA
authors: Nicolini
authors: Maria
authors: M
authors: Auxiliadora-Martins
authors: Orlando de Castro e
authors: Ode C
authors: Silva
mesh_terms: D018806:APACHE; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood*; D058625:End Stage Liver Disease / Q000097:blood / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D019344:Lactic Acid / Q000097:blood*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D019344:Lactic Acid; D003404:Creatinine; D001663:Bilirubin