지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.10
- 수록면
- 353 - 359 (7page)
- DOI
- 10.17085/apm.21049
이용수
초록· 키워드
오류제보하기
Background: Generally, lactate levels > 2 mmol/L represent hyperlactatemia, whereas lactic acidosis is often defined as lactate > 4 mmol/L. Although hyperlactatemia is common finding in liver transplant (LT) candidates, association between lactate and organ failures with Acute-on-chronic Liver Failure (ACLF) is poorly studied. We searched the important variables for pre-LT hyperlactatemia and examined the impact of preoperative hyperlactatemia on early mortality after LT. Methods: A total of 2,002 patients from LT registry between January 2008 and February 2019 were analyzed. Six organ failures (liver, kidney, brain, coagulation, circulation, and lung) were defined by criteria of EASL-CLIF ACLF Consortium. Variable importance of preoperative hyperlactatemia was examined by machine learning using random survival forest (RSF). Kaplan-Meier Survival curve analysis was performed to assess 90-day mortality.Results: Median lactate level was 1.9 mmol/L (interquartile range: 1.4, 2.4 mmol/L) and 107 (5.3%) patients showed > 4.0 mmol/L. RSF analysis revealed that the four most important variables for hyperlactatemia were MELD score, circulatory failure, hemoglobin, and respiratory failure. The 30-day and 90-day mortality rates were 2.7% and 5.1%, whereas patients with lactate > 4.0 mmol/L showed increased rate of 15.0% and 19.6%, respectively. Conclusion: About 50% and 5% of LT candidates showed pre-LT hyperlactatemia of > 2.0 mmol/L and > 4.0 mmol/L, respectively. Pre-LT lactate > 4.0 mmol/L was associated with increased early post-LT mortality. Our results suggest that future study of correcting modifiable risk factors may play a role in preventing hyperlactatemia and lowering early mortality after LT.
목차
등록된 정보가 없습니다.
참고문헌 (17)
참고문헌 신청
Cardoso FS / 2019 / Lactate and number of organ failures predict intensive care unit mortality in patients with acute-on-chronic liver failure / Liver Int 39:1271~1280
Sundaram V / 2019 / Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation / Gastroenterology 156:1381~1391
Weiss SL / 2020 / Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children / Intensive Care Med 46(Suppl 1):10~67
Jeppesen JB / 2013 / Lactate metabolism in chronic liver disease / Scand J Clin Lab Invest 73:293~299
Jalan R / 2014 / Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure / J Hepatol 61:1038~1047
Sundaram V / 2019 / Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation / Gastroenterology 156:1381~1391
Weiss SL / 2020 / Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children / Intensive Care Med 46(Suppl 1):10~67
Jeppesen JB / 2013 / Lactate metabolism in chronic liver disease / Scand J Clin Lab Invest 73:293~299
Jalan R / 2014 / Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure / J Hepatol 61:1038~1047
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