Blood Lactate During Double-Lung Transplantation: A Predictor of Grade-3 Primary Graft Dysfunction

Year in Review 2023: Noteworthy Literature in Cardiothoracic Transplantation

“…Consistent with these findings, the re-transplantation group demonstrated higher intraoperative blood lactate levels, received greater volumes of blood transfusion, and required higher doses of vasopressor support. The Foch Group has previously reported on the negative impact of elevated lactate 6 and blood transfusion 7 on lung transplantation outcomes, but interestingly, the rates of severe primary graft dysfunction (PGD) were comparable between the 2 groups in this study. These data suggest that although a re-transplantation carried out in the context of CF is likely to be more technically challenging than a primary transplantation, it could nonetheless be a potentially viable approach in terms of mortality and PGD.…”

New Aspects of Lung Transplantation: A Narrative Overview Covering Important Aspects of Perioperative Management

“…But the practicality of such measurements is far from certain, unlike the simple measure of intraoperative blood lactate level as reported in a monocenter study which brought together 449 patients, 16% of them patients having a grade 3 PGD at day 3. In this study, a value below the threshold of 2.6 mmol/L at the end of surgery has a high negative predictive value for the occurrence of a grade 3 PGD at day 3 [ 70 ]. Finally, a recent study confirmed the data of an earlier one which had put forward the predictive role of an early measurement of extravascular lung water index [ 71 , 72 ].…”

Initial experience and outcomes with a hybrid extracorporeal membrane oxygenation and cardiopulmonary bypass circuit for lung transplantation

“…Data supporting peak lactate in lung transplantation as a marker of systemic perfusion adequacy are limited, but elevated lactate level was associated with worse outcomes in a heterogenous off-pump/ECLS support model. 22 …”