Evidence map›Paper›PMID 41667251›Full record

ArticleAnesthesia and pain medicine2026

Intraoperative lactate level and lactate clearance is associated with long-term mortality in liver transplant recipients.

Akira Katayama, Ezeldeen Abuelkasem, Marianne M Ligon, Yaroslava Longhitano, David W Wang

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Article in Anesthesia and pain medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

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5 authors.

Akira KatayamaDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ezeldeen AbuelkasemDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Marianne M LigonDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Yaroslava LonghitanoDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
David W WangDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHyperlactatemia has been associated with poor outcomes in various clinical settings including liver transplantation (LT). However, the impact of intraoperative lactate levels and lactate clearance on long-term mortality in LT recipients remains unclear.

methodsWe retrospectively reviewed data from 1,067 patients who underwent LT. All lactate data measured intraoperatively were used to calculate the time-weighted average lactate (TWAL) method. Lactate clearance was calculated as the difference between lactate levels immediately after reperfusion and at the end of surgery. Multivariable analyses were performed to identify independent predictors of mortality after LT.

resultsHigher lactate group showed significantly worse survival at 30-days, 1-year, and 3-years (P = 0.01, P < 0.001, and P < 0.001, respectively), and lactate clearance was significantly lower in non-survivors (P = 0.003, P = 0.003, and P = 0.002, respectively). Multivariable analyses revealed that the TWAL was independently associated with each mortality timepoint (hazard ratio [HR], 1.41, 95% confidence interval [CI], 1.19-1.67; P < 0.001, HR, 1.29, 95% CI, 1.17-1.42; P < 0.001, HR, 1.20, 95% CI, 1.10-1.30; and P < 0.001, respectively). Furthermore, lactate clearance was also an independent predictor for each mortality timepoint (HR, 0.69, 95% CI, 0.60-0.80; P < 0.001, HR, 0.80, 95% CI, 0.73-0.88; P < 0.001, and HR, 0.83, 95% CI, 0.77-0.90; P < 0.001, respectively).

conclusionsBoth intraoperative lactate level and lactate clearance were independently associated with mortality after LT. Intraoperative lactate monitoring may help predict both short- and long-term mortality in LT recipients.

Indexed as

Intraoperative periodLactic acidLiver transplantationMetabolic clearance rateMortalityPrognosis

Identifiers

PMID41667251
PMCPMC12890539

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