부산대학교 도서관

Purpose: We examined the ability of the P(v‐a)CO2/Da‐vO2 ratio combined with elevated lactate levels to predict early allograft dysfunction (EAD). Materials and methods: Patients were classified into four groups according to lactate levels and P(v‐a)CO2/Da‐vO2 ratio: Group 1; lactate >2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio >1.0; Group 2; lactate >2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio <1.0; group 3; lactate<2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio >1.0; group 4; lactate<2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio <1.0. We defined EAD according to Olthoff criteria. Results: One‐hundred and fifty patients were included. EAD occurred in 41 patients (27.3%), and was associated with worse graft survival at 1 year (92% vs. 73%; P = ,003) as well as a higher re‐transplantation rate (4,6% vs. 17,1%; P = ,019). The multivariate analysis revealed that P(v‐a)CO2/Da‐vO2 ratio at T6 [OR 7.05(CI95% 2.77–19.01, P<.001)] was an independent predictor for EAD. Belonging to group 1 at 6 h was associated with worse clinical outcomes but no association was found with 1‐year graft survival or 1‐year patient survival. Conclusions: In this single center, prospective, observational study in patients who received an OLT, we found that elevated lactate levels combined with a high Cv‐aCO2/Da‐vO2 after 6 h was associated with the development of EAD and worse clinical outcomes in the early postoperative period. [ABSTRACT FROM AUTHOR]