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 Cardiovascular Surgery

UniBE Contributor:

Mohacsi, Paul; Tanner, Hildegard; Hullin, Roger and 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:

19 Jun 2014 11:21

PubMed ID:

11959046

URI:

https://boris.unibe.ch/id/eprint/42334

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