RT Journal Article
T1 Prognostic Value of Serum Lactate Levels in Patients Undergoing Urgent Heart Transplant: A Subanalysis of the ASIS-TC Spanish Multicenter Study.
A1 Couto-Mallón, David
A1 González-Vílchez, Francisco
A1 Almenar-Bonet, Luis
A1 Díaz-Molina, Beatriz
A1 Segovia-Cubero, Javier
A1 González-Costello, José
A1 Delgado-Jiménez, Juan
A1 Castel-Lavilla, María A
A1 Crespo-Leiro, María G
A1 Rangel-Sousa, Diego
A1 Martínez-Sellés, Manuel
A1 Rábago-Juan-Aracil, Gregorio
A1 De-la-Fuente-Galán, Luis
A1 Blasco-Peiró, Teresa
A1 Hervás-Sotomayor, Daniela
A1 Garrido-Bravo, Iris P
A1 Mirabet-Pérez, Sonia
A1 Muñiz, Javier
A1 Barge-Caballero, Eduardo
K1 Asistencia circulatoria mecánica
K1 Heart transplant
K1 Lactate
K1 Lactato
K1 Mechanical circulatory support
K1 Trasplante cardiaco
AB To study the prognostic value of serum lactate in patients under temporary preoperative mechanical circulatory support who underwent urgent heart transplant. We conducted a subanalysis of a Spanish multicenter registry recording data on patients under temporary mechanical circulatory support listed for highly urgent heart transplant from 2010 to 2015. Participants selected for the present study were those who received a transplant and who had known preoperative serum lactate levels. The main study outcome was 1-year survival after transplant. A total of 177 heart transplant recipients were studied; preoperatively, 90 were supported on venoarterial extracorporeal membrane oxygenation, 51 on temporary left ventricular assist devices, and 36 on temporary biventricular assist devices. Preoperative hyperlactatemia (≥ 2 mmol/L) was present in 44 (25%) patients. On multivariable analysis, pretransplant serum lactate was identified as an independent predictor of 1-year posttransplant survival (adjusted HR per 0.1 mmol/L, 1.02; 95%CI, 1.01-1.03; P = .007). One-year posttransplant survival was 53.1% (95%CI, 45.3-60.9) in patients with preoperative hyperlactatemia and 75.6% (95%CI, 71.8-79.4) in those without preoperative hyperlactatemia (adjusted HR, 1.94; 95%CI, 1.04-3.63; P = .039). Preoperative hyperlactatemia correlated with adverse outcomes in patients supported with extracorporeal membrane oxygenation, but not in patients supported on ventricular assist devices. Preoperative serum lactate is a strong independent predictor of worse outcomes in patients undergoing urgent heart transplant on short-term mechanical circulatory support.
YR 2018
FD 2018-05-30
LK https://hdl.handle.net/10668/26876
UL https://hdl.handle.net/10668/26876
LA en
LA es
DS RISalud
RD Apr 6, 2025