Analysis of predictors for lactate elimination after reperfusion in recipients of living-donor liver transplantation

Background Graft-recipient weight ratio (GRWR) is the only documented predictor that influences the lactate elimination after reperfusion in living-donor liver transplantation (LDLT). This study was performed to investigate the predictors of lactate elimination after reperfusion in recipients of adult LDLT. Methods The medical records of 159 patients who underwent LDLT were analyzed. Lactate level (mmol/L) was measured from just before the initiation of surgery (P₀) and 5, 60, and 120 minutes after reperfusion of graft (R₀, R₁, and R₂, respectively). The change of lactate level after reperfusion was defined as difference between lactate level measured at R₀ and R₂. Patients were divided into accumulation and elimination groups. Donor and recipient factors were compared between the 2 groups. Results Lactate accumulation occurred in 80 of 159 recipients (50.3%), and elimination occurred in 79 (49.7%). GRWR and Model for End-Stage Liver Disease (MELD) score were higher in the elimination group. Lactate at R₀ was lower in the elimination group. Conclusions Higher GRWR and MELD score and lower lactate level immediate after reperfusion of graft were predictors of lactate elimination after reperfusion during adult LDLT.