Twenty-four hours lactate clearance in prediction of early postoperative complications following liver transplantation        WU Jian-feng, GUAN Xiang-dong, CHEN Juan, et al. Department of SICU, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
 Corresponding author: GUAN Xiang-dong, E-mail carlg @163.net
Abstract    Objective    To evaluate the clinical utility of 24h lactate clearance as predictor for early postoperative complications following liver transplantation. Methods    MELD score, Child score, 24h lactate clearance and early postoperative complications in 7 days of 172 patients admitted to SICU after liver transplantation between January 2007 and December 2009 in the First Affiliated Hospital of Sun Yat-sen University were collected and studied prospectively. All the patients were divided into non-complication group and complication group. The 24h lactate clearances between two groups were compared. Receiver operating characteristic (ROC) curves were plotted to measure the performance of the early lactate clearance. Results    Early complications occurred in 36 of overall 172 patients (20.9%). The 24h lactate clearance in non-complication group was significantly higher than that in complication group [(51.4±18.6)% vs (17.3±11.2)%, P<0.001]. The optimum cut-off value for 24h lactate clearance predicting early complications was 34.5% (sensitivity 95.3%, specificity 86.0%). The area under the curve of the ROC was 0.951±0.016（P<0.001）. Conclusion The 24h lactate clearance could serve as a prompt and accurate bedside predictor for early postoperative complications after liver transplantation. Patients with 24h lactate clearance less than 34.5% are associated with higher incidence of early postoperative complications.