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Lactate Dynamic Changes as a Predictive Tool for Early Primary Graft Dysfunction After Lung Transplantation: A
Ting Lin1, Sinan Liu1, Ying Zhao1
1Department of Surgical Intensive Care Unit, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Transplantation Proceedings
|June 11, 2026
Summary
Elevated lactate levels 6 hours post-transplant and slow clearance indicate a higher risk of primary graft dysfunction (PGD) after lung transplantation. Monitoring lactate dynamics aids in early PGD detection.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Transplantation Surgery
Background:
- Primary graft dysfunction (PGD) is a severe complication following lung transplantation.
- Objective indicators for real-time PGD management within 24 hours post-surgery are lacking.
- Current assessment relies heavily on oxygenation indices.
Purpose of the Study:
- To investigate the utility of lactate dynamics in predicting PGD after lung transplantation.
- To identify early biochemical markers for PGD development.
Main Methods:
- Retrospective analysis of 74 lung transplant recipients.
- Classification into PGD and non-PGD groups.
- Analysis of lactate levels and dynamic changes within 24 hours post-ICU admission.
Main Results:
- Higher lactate levels observed in the PGD group at 0, 3, and 6 hours post-ICU admission (P < .01).
- Significant differences in lactate clearance from 6 to 24 hours (L6-L24) between groups (P < .015).
- L6-L24 emerged as an independent protective factor against PGD (P = .04).
Conclusions:
- Increased 6-hour lactate levels are a significant warning sign for PGD.
- Delayed lactate clearance between 6 and 24 hours post-transplant predicts PGD development.
- Lactate dynamics offer valuable insights for early PGD detection and management.
