Lactic acidosis following heart transplantation: a common phenomenon?

Mohacsi, Paul; Pedrazzinia, Giovanni; Tanner, Hildegard; Tschanz, Hans-Ueli; Hullin, Roger; Carrel, Thierry (2002). Lactic acidosis following heart transplantation: a common phenomenon? European journal of heart failure, 4(2), pp. 175-179. Oxford University Press

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BACKGROUND

Lactic acidosis (LAc) is a common form of metabolic acidosis early after heart transplantation (HTX). The mechanism remains unclear. This study analyzed 13 patients who developed severe LAc after HTX.

METHODS

From a series of 60 consecutive heart transplant patients, we identified 13 patients with LAc in the first hours following HTX. Nine patients with normal or mildly elevated lactate levels (<5.0 mmol/l) were investigated as controls.

RESULTS

Thirteen patients developed a moderate or severe LAc (up to 14.6 mmol/l) after HTX. Serum lactate levels increased immediately following surgery with a peak after 6.3+/-1.4 h, spontaneously returning to normal values within 24 h. In contrast to the control group, a significant correlation was found between the maximal serum lactate level and the maximal dosage of inotropic drugs (r=0.93, P<0.02), administered during the reperfusion phase and continued for 12-24 h postoperatively. No correlation was found between LAc and blood gas analysis during extracorporeal perfusion period.

CONCLUSION

LAc can occur after HTX and seems to be related to the inotropic support of the graft. In contrast to other forms, LAc after HTX has an excellent prognosis and resolves rapidly and spontaneously without treatment. The fact that inotropic support during and immediately after cardiac transplantation can enhance preexisting severe peripheral metabolic cellular dysfunction remains hypothetical.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Herz- und Gefässchirurgie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Herz- und Gefässchirurgie 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery
UniBE Contributor:	Mohacsi, Paul, Tanner, Hildegard, Hullin, Roger, Carrel, Thierry
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1388-9842
Publisher:	Oxford University Press
Language:	English
Submitter:	Hildegard Tanner
Date Deposited:	19 Jun 2014 11:21
Last Modified:	27 Feb 2024 14:30
PubMed ID:	11959046
URI:	https://boris.unibe.ch/id/eprint/42334