Impact of postoperative hyperlactatemia in orthotopic heart transplantation

Hyperlactatemia (HL) is a common phenomenon after cardiac surgery which is related to tissue hypoperfusion and hypoxia and associated with poor outcomes. It is also often seen in the postoperative period after orthotopic heart transplantation (OHTx), but the association between HL and outcomes after...

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Bibliographic Details
Published in:Journal of cardiology 2024-10, Vol.84 (4), p.239-245
Main Authors: Doi, Atsuo, Batchelor, Riley, Demase, Kathryn C., Manfield, Jaimi C., Burrell, Aidan, Paul, Eldho, Marasco, Silvana F., Kaye, David, McGiffin, David C.
Format: Article
Language:English
Subjects:
Adult
Extracorporeal Membrane Oxygenation
Female
Heart Transplantation - adverse effects
Humans
Hyperlactatemia
Hyperlactatemia - etiology
Incidence
Lactic Acid - blood
Lactic acidosis
Length of Stay
Male
Middle Aged
Orthotopic heart transplantation
Postoperative Complications - etiology
Respiration, Artificial
Retrospective Studies
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Summary:Hyperlactatemia (HL) is a common phenomenon after cardiac surgery which is related to tissue hypoperfusion and hypoxia and associated with poor outcomes. It is also often seen in the postoperative period after orthotopic heart transplantation (OHTx), but the association between HL and outcomes after OHTx is not well known. We evaluated the incidence and outcome of HL after OHTx. This was a retrospective study of 209 patients who underwent OHTx between January 2011 and December 2020. Patients were classified into 3 groups according to their peak lactate levels within the first 72 h postoperatively: group 1, normal to mild hyperlactatemia (10 mmol/L, n = 57). The primary composite endpoint was all-cause mortality or postoperative initiation of veno-arterial extracorporeal membrane oxygenation (VA ECMO) within 30 days. Secondary endpoints included duration of mechanical ventilation, intensive care unit length of stay, and hospital length of stay. Patients with higher postoperative peak lactate levels were more commonly transplanted from left ventricular assist device support (33.3 % vs 50.9 % vs 64.9, p 
ISSN:0914-5087
1876-4738
1876-4738
DOI:10.1016/j.jjcc.2024.02.001