Abstract：
The post-operative course after Liver Transplantation (LT) can be complicated by early allograft dysfunction (EAD), primary nonfunction (PNF) and death. A lactate concentration at the end of transplant of ≥5 mmol/L was recently proposed as a predictive marker of PNF, EAD, and mortality; this study aimed to validate these previous reports in a large single center cohort.
This retrospective cohort study included adult liver transplant recipients who received grafts from deceased donors at our center between June 2012 and May 2021. Receiver operating characteristic (ROC) curves for the lactate concentration at the end of transplantation were computed to determine the AUC for PNF, EAD and mortality at 90 days.
In our cohort of 1137 cases, the AUCs for lactate to predict EAD, PNF and mortality were respectively .56 (95% confidence interval [CI]: .53-.60), .69 (95% CI: .52-.85), and .74 (95% CI: .63-.84).
The clinical value of lactate concentration at the end of transplantation to predict PNF, EAD and mortality at 90 days was, at best, modest, as shown by the relatively low AUCs. Our findings cannot validate previous reports that the lactate level alone is a good predictor of poor outcomes after liver transplantation.
This retrospective cohort study included adult liver transplant recipients who received grafts from deceased donors at our center between June 2012 and May 2021. Receiver operating characteristic (ROC) curves for the lactate concentration at the end of transplantation were computed to determine the AUC for PNF, EAD and mortality at 90 days.
In our cohort of 1137 cases, the AUCs for lactate to predict EAD, PNF and mortality were respectively .56 (95% confidence interval [CI]: .53-.60), .69 (95% CI: .52-.85), and .74 (95% CI: .63-.84).
The clinical value of lactate concentration at the end of transplantation to predict PNF, EAD and mortality at 90 days was, at best, modest, as shown by the relatively low AUCs. Our findings cannot validate previous reports that the lactate level alone is a good predictor of poor outcomes after liver transplantation.
摘要：
背景：肝移植（LT）术后过程可能会并发早期同种异体移植功能障碍（EAD），原发性无功能（PNF）和死亡。移植结束时的乳酸浓度≥5mmol/L最近被提出作为PNF的预测指标，EAD,和死亡率;这项研究旨在在大型单中心队列中验证这些以前的报告。
方法：这项回顾性队列研究包括2012年6月至2021年5月在我们中心接受已故捐献者移植的成年肝移植受者。计算移植结束时乳酸浓度的受试者工作特征（ROC）曲线以确定PNF的AUC，EAD和90天的死亡率。
结果：在我们的1137例病例队列中，乳酸的AUC预测EAD，PNF和死亡率分别为.56（95%置信区间[CI]：.53-.60），.69（95%CI：.52-.85），和.74（95%CI：.63-.84）。
结论：移植结束时乳酸浓度预测PNF的临床价值，EAD和90天的死亡率是，充其量,谦虚,如相对较低的AUC所示。我们的发现无法验证先前的报道，即单独的乳酸水平是肝移植后不良结局的良好预测指标。
方法：这项回顾性队列研究包括2012年6月至2021年5月在我们中心接受已故捐献者移植的成年肝移植受者。计算移植结束时乳酸浓度的受试者工作特征（ROC）曲线以确定PNF的AUC，EAD和90天的死亡率。
结果：在我们的1137例病例队列中，乳酸的AUC预测EAD，PNF和死亡率分别为.56（95%置信区间[CI]：.53-.60），.69（95%CI：.52-.85），和.74（95%CI：.63-.84）。
结论：移植结束时乳酸浓度预测PNF的临床价值，EAD和90天的死亡率是，充其量,谦虚,如相对较低的AUC所示。我们的发现无法验证先前的报道，即单独的乳酸水平是肝移植后不良结局的良好预测指标。
