1
|
Deniau B, Sen J, Chaussard M, Boutin L, Coutrot M, Guillemet L, Plaud B, Depret F, Dudoignon E. Early post-operative lactate increase following kidney transplant is associated with delayed graft function: A retrospective cohort study. Clin Transplant 2024; 38:e15288. [PMID: 38520246 DOI: 10.1111/ctr.15288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Delayed graft function (DGF) is a frequent complication following kidney transplant. This study aimed to assess the association between early post-operative lactate variation and DGF. METHODS This was a single center, retrospective cohort study between February 2021 and December 2022 in Saint-Louis Hospital (APHP, France). Venous lactate levels were measured immediately (H0) and 4 h (H4) after kidney transplant. The primary outcome was the occurrence of DGF (need for renal replacement therapy between transplantation and day 7). Secondary outcome was the occurrence of complications (i.e., death, vascular thrombosis, hemorrhagic shock, urological complications (hematoma, urinoma), local or systemic infection) between transplant and day 7. RESULTS Two hundred 12 patients were included, and 38 (17.9%) developed DGF. Venous lactate variation between H0 and H4 was higher in patients who developed DGF (-30 (IQR -83, -6)% vs. -15 (IQR -62, -11)%, p = .037), but the variation of level was more often positive (corresponding to an increased lactate production over time between H0 and H4) in patients who developed DGF ((28(85%) vs. 94(62%), p = .011). In multivariate logistic regression, positive venous lactate level variation between H0 and H4 was strongly associated with a reduced risk of developing DGF (OR .30 [.09-.79], p = .024). We did not find any association between post-operative hyperlactatemia and occurrence of complications between transplant and day 7. DISCUSSION DGF is a frequent complication following kidney transplantation. Its early prediction could help physicians optimize treatment and protect the kidney. Early venous lactate variation after kidney transplant could help to predict the occurrence of DGF.
Collapse
Affiliation(s)
- Benjamin Deniau
- Université de Paris Cité, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
- FHU PROMICE, Paris, France
- INI CRCT, Paris, France
| | - Juliane Sen
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
| | - Maïté Chaussard
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
| | - Louis Boutin
- Université de Paris Cité, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
- FHU PROMICE, Paris, France
| | - Maxime Coutrot
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
| | - Lucie Guillemet
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
| | - Benoit Plaud
- Université de Paris Cité, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
- FHU PROMICE, Paris, France
| | - François Depret
- Université de Paris Cité, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
- FHU PROMICE, Paris, France
- INI CRCT, Paris, France
| | - Emmanuel Dudoignon
- Université de Paris Cité, Paris, France
- INSERM UMR-S 942, Cardiovascular Markers in Stress Condition (MASCOT), Université de Paris Cité, Paris, France
- Department of Anesthesiology, Critical Care and Burn Unit, University Saint-Louis-Lariboisière Hospital, AP-HP, Paris, France
- FHU PROMICE, Paris, France
| |
Collapse
|