The Monitoring And Significance Of Arterial Blood Lactate Level During Orthotopic Liver Transplantation Operation

Objective To investigate the clinical significance and relationship of arterial blood lactate level and liver function,renal function,whole body oxygen metabolism during orthotopic liver transplantation(OLT)operation.Methods Between December 2005 and February 2007,16 consecutive patients underwent OLT,male 13 cases and female 3 cases,35 to 67 years old(mean,46.50±9.37),including 6 cases of liver cirrhosis because of HBV,3 patients of primary hepatic carcinoma,both liver cirrhosis because of HBV and primary hepatic carcinoma were 6 cases,and only one patient of fatty liver cirrhosis.Single patient after hepatic transplantation died of hepatic failure within 1 month,other patients after hepatic transplantation might live within 6 months.After operation,all patients were send to surgical intensive care unit(SICU)of First Affiliated Hospital of Guangxi Medical University.The patients' physiological function were detected,the symptoms and signs were observed,the blood lactate level and liver function,renal function were measured before,during and after operation 1,12,24,48,72 hours,observed changes and analyzed relativity factors.Results In the 16 patients,when compared to preoperative,the arterial blood lactate level were significantly higher in operation 1,12,24hours (P＜0.05).The liver function(ALT,AST)came back favorable which the arterial blood lactate level were decreased rapidly to normal.They had positive correlation(R=0.27,P=0.008;R=0.54,P＜0.01);Likewise,the renal function was not changed obviously,the arterial blood lactate and blood creatinine had no correlation;Otherwise,the arterial blood lactate and A-PA-PaO₂ had positive correlation(R=0.47,P＜0.01).Conclusion The blood lactate level will be an important parameter that decision liver function and whole body oxygen metabolism after orthotopic liver transplantation(OLT).The lacticemia was disappeared after operation 48h.To evaluate and monitoring the blood lactate levels are excellent indicators of estimate orthotopic liver transplantation(OLT)prognosis.