期刊论文详细信息
Acta Cirurgica Brasileira
Can joint analysis of postoperative MELD, base excess and blood lactate levels be used as an index of postoperative outcome for patients submitted to liver transplantation?
Nathalia Cardoso2  Tiago Silva1  Daniel Cagnolati1  Thiago Freitas1  Enio David Mente1  Anibal Basile-filho1  Orlando Castro E Silva1 
[1] ,University of São Paulo Faculty of Medicine of Ribeirão Preto Department of Surgery and AnatomyRibeirão Preto SP ,Brazil
关键词: Lactic acid;    Liver Transplantation;    Severity of Illness Index;    Prognosis;    Ácido Láctico;    Transplante de Fígado;    Índice de gravidade de doença;    Prognóstico;   
DOI  :  10.1590/S0102-86502013001300011
来源: SciELO
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【 摘 要 】

PURPOSE: The objective of the present study was to evaluate the postoperative levels of classical or pure MELD and changes in lactate or base excess (BE) levels as possible predictive factors of the type of outcome of patients submitted to orthotopic liver trasplantation (OLT). METHODS: The study was conducted on 60 patients submitted to OLT at the University Hospital, Faculty of Medicine of Ribeirão Preto, USP, between October 2008 and March 2012. The 30 latest survivor (S) and non-survivor (NS) cases were selected. All liver transplants were performed using the piggy-back technique. ALT, AST, BE and blood lactate values were determined for each group at five time points (immediate preoperative period, end of hypothermal ischemia, 5 and 60 minutes after arterial revascularization and in the immediate postoperative period, when the postoperative MELD was also calculated. RESULTS: The aminotransferases reached a maximum increase 24 hours after surgery in both the S and NS groups. There was a significantly higher increase in BE and blood lactate in the NS group, especially after 5 minutes of afterial reperfusion of the graft, p<0.05. There was no significant difference in preoperative MELD between groups (p>0.05), while the postoperative MELD was higher in the NS than in the S group (p<0.05) CONCLUSION: Joint analysis of postoperative MELD, BE and blood lactate can be used as an index of severity of the postoperative course of patients submitted to liver transplantation.

【 授权许可】

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