ArticleAnesthesia and pain medicine2022
Intraoperative lactic acid concentration during liver transplantation and cutoff values to predict early mortality: a retrospective analysis of 3,338 cases.
Article in Anesthesia and pain medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Bicarbonate-buffered solution versus Plasma-LyteTM in orthotopic adult liver transplantation: a pilot open-label, randomized, non-inferiority trial.Korean journal of anesthesiology · 2025Trial
- Continuous Renal Replacement Therapy During Liver Transplant: The Anesthesiologist-Nephrologist Collaboration at a Tertiary University Hospital in Italy.Clinical transplantation · 2026Article
- Intraoperative lactate level and lactate clearance is associated with long-term mortality in liver transplant recipients.Anesthesia and pain medicine · 2026Article
- The Lactate-Primed KAT8‒PCK2 Axis Exacerbates Hepatic Ferroptosis During Ischemia/Reperfusion Injury by Reprogramming OXSM-Dependent Mitochondrial Fatty Acid Synthesis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Liver transplant and the sweet-bitter truth.Anesthesia and pain medicine · 2022Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundWe aimed to explore the distribution of intraoperative lactic acid (LA) level during liver transplantation (LT) and determine the optimal cutoff values to predict post-LT 30-day and 90-day mortality.
methodsIntraoperative LA data from 3,338 patients were collected between 2008 to 2019 and all-cause mortalities within 30 and 90 days were retrospectively reviewed. Of the three LA levels measured during preanhepatic, anhepatic, and neohepatic phase of LT, the peak LA level was selected to explore the distribution and predict early post-LT mortality. To determine the best cutoff values of LA, we used a classification and regression tree algorithm and maximally selected rank statistics with the smallest P value.
resultsThe median intraoperative LA level was 4.4 mmol/L (range: 0.5-34.7, interquartile range: 3.0-6.2 mmol/L). Of the 3,338 patients, 1,884 (56.4%) had LA levels > 4.0 mmol/L and 188 (5.6%) had LA levels > 10 mmol/L. Patients with LA levels > 16.7 mmol/L and 13.5-16.7 mmol/L showed significantly higher 30-day mortality rates of 58.3% and 21.2%, respectively. For the prediction of the 90-day mortality, 8.4 mmol/L of intraoperative LA was the best cutoff value.
conclusionsApproximately 6% of the LT recipients showed intraoperative hyperlactatemia of > 10 mmol/L during LT, and those with LA > 8.4 mmol/L were associated with significantly higher early post-LT mortality.
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