摘要BACKGROUND:?Initial?poor?graft?function?(IPGF)?following?orthotopic? liver? transplantation? is? a? major? determinant? of?postoperative? survival? and? morbidity.? Lactate? clearance? is? a?good?marker?of?liver?function.?In?this?study,?we?investigated?the? clinical? utility? of? early? lactate? clearance? as? an? early? and?accurate?predictor?for?IPGF?following?liver?transplantation. METHODS:?This?was?a?prospective?observational?study?of?222?patients?referred?to?the?surgical?intensive?care?unit?(SICU)?after?orthotopic?liver?transplantation.?The?IPGF?group?consisted?of?patients?with?alanine?aminotransferase?(ALT)?and/or?aspartate?aminotransferase? (AST)? >1500? IU/L? within? 72? hours? after?orthotopic? liver? transplantation.? Early? lactate? clearance? was?defined?as?lactate?at?SICU?presentation?(hour?0)?minus?lactate?at?hour?6,?divided?by?lactate?at?SICU?presentation.?The?model?for?end-stage?liver?disease?(MELD)?score,?Child-Pugh?score?and?laboratory?data?including?AST,?ALT,?total?bilirubin?(TB)?and?prothrombin? time? (PT)? were? recorded? at? SICU? presentation?and? compared? between? the? non-IPGF? and? IPGF? groups.?Receiver? operating? characteristic? (ROC)? curves? were? plotted?to?measure?the?performance?of?early?lactate?clearance,?MELD?score,?Child-Pugh?score,?TB?and?PT. <br> RESULTS:?IPGF?occurred?in?45?of?the?222?patients?(20.3%).?The?early? lactate? clearance? in? the? non-IPGF? group? was? markedly?higher?than?that?in?the?IPGF?group?(43.2±13.8%?vs?13.4±13.7%?P<0.001).?The?optimum?cut-off?value?for?early?lactate?clearance?predicting? IPGF? was? 24.8%? (sensitivity? 95.5%,? specificity?88.9%).?The?area?under?the?curve?of?the?ROC?was?0.961,?which?was? significantly? superior? to? MELD? score,? Child-Pugh? score,?TB?and?PT.?Patients?with?early?lactate?clearance? ≤24.8%?had?a?higher?IPGF?rate?(OR=169)?and?a?higher?risk?of?in-hospital?mortality?(OR=3.625). <br> CONCLUSIONS:?Early?lactate?clearance?can?serve?as?a?prompt?and? accurate? bedside? predictor? of? IPGF.? Patients? with? early?lactate?clearance?less?than?24.8%?are?associated?with?a?higher?incidence?of?IPGF.