Peri-operative blood lactate levels in recipients of living-related liver transplantation

Background. The role of changes in peri-operative blood lactate levels in r ecipients 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 mu cosal PCO2 levels were measured at six time points during surgery: just bef ore the initiation of surgery, just after dissection of the hepatic vascula ture, at the end of the anhepatic phase, and 30, 60, and 120 min after repe rfusion, me calculated the rate of lactate accumulation during the pre-anhe patic and anhepatic phases and the elimination rate during reperfusion (neo hepatic phase), and examined the correlation between these results and the clinical findings. Results. The rate of lactate elimination during the neohepatic phase was co rrelated with the ratio of graft weight to standard Liver volume (P<0.0001) , There was also a significant correlation between the rate of lactate accu mulation during the pre-anhepatic phase and the preoperative total bilirubi n levels (P=0.0008). Conclusions. Each pre-anhepatic, anhepatic, and neohepatic phase had a char acteristic blood lactate profile, The graft size strongly affected lactate levels during the early neohepatic phase.