{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:55:12Z","timestamp":1785779712699,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006506","name":"Minist\u00e9rio da Sa\u00fade","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Although lactate levels and lactate clearance are associated with outcomes in shock states, their prognostic value in brain\u2010dead potential organ donors remains unclear and is not mentioned in clinical guidelines as a perfusion marker to guide clinical intervention. We aimed to evaluate whether lactate levels and lactate clearance may predict losses of brain\u2010dead potential organ donors to cardiac arrest. This was a secondary analysis embedded within the cluster\u2010randomized DONORS trial. Participants were stratified according to baseline lactate level: &lt;2\u00a0mmol\/L and \u22652\u00a0mmol\/L. Individuals with lactate measurements at enrollment and after 6 h were classified according to lactate clearance: &lt;10% or \u226510%. The primary outcome was loss of potential donors to cardiac arrest prior to organ procurement. Among 1043 participants, those with baseline lactate \u22652\u00a0mmol\/L were more likely to develop cardiac arrest (53\/386 [13.7%] vs. 62\/657 [9.4%];\n                    <jats:italic>p =<\/jats:italic>\n                    0.016) and less likely to become actual donors (151\/386 [39.1%] vs. 308\/657 [46.9%];\n                    <jats:italic>p =<\/jats:italic>\n                    0.022). In adjusted analyzes, baseline lactate \u22652.0\u00a0mmol\/L was associated with increased risk of cardiac arrest (OR, 1.59; 95% CI, 1.09\u20132.33;\n                    <jats:italic>p =<\/jats:italic>\n                    0.016). High lactate clearance was associated with more cardiac arrests (OR, 3.44; 95% CI, 1.61\u20137.14;\n                    <jats:italic>p =<\/jats:italic>\n                    0.001). Elevated baseline lactate identifies brain\u2010dead potential donors at increased risk of cardiac arrest, whereas a lactate clearance &lt;10% was associated with a higher risk.\n                  <\/jats:p>","DOI":"10.1111\/ctr.70599","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:33:22Z","timestamp":1782275602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lactate and Lactate Clearance as Outcome Predictors in Brain\u2010Dead Potential Organs: A Secondary Cohort Analysis Embedded Within a Cluster\u2010Randomized Clinical Trial"],"prefix":"10.1111","volume":"40","author":[{"given":"Glauco Adrieno","family":"Westphal","sequence":"first","affiliation":[{"name":"Hospital Moinhos de Vento (HMV)  Porto Alegre Rio Grande do Sul Brazil"},{"name":"Central Estadual de Transplantes de Santa Catarina  Florian\u00f3polis Santa Catarina Brazil"},{"name":"Centro Hospitalar Unimed Joinville  Joinville Santa Catarina Brazil"},{"name":"Hospital Municipal S\u00e3o Jos\u00e9  Joinville Santa Catarina Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Biasi","family":"Cavalcanti","sequence":"additional","affiliation":[{"name":"HCor Research Institute  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Cabral","family":"Robinson","sequence":"additional","affiliation":[{"name":"MOVE Academic Research Organization\u2013Hospital Moinhos de Vento  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Elis","family":"Giordani","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento (HMV)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassiano","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre (HCPA)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriane Isabel","family":"Rohden","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento (HMV)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Passos","family":"Gimenes","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade, Bras\u00edlia  Distrito Federal Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e1tia Moreira","family":"Guterres","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento (HMV)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itiana Cardoso","family":"Madalena","sequence":"additional","affiliation":[{"name":"Teaching and Research Institute Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo 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Augusto","family":"Franke","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre (HCPA)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Augusto","family":"Bozza","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Disease Evandro Chagas Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ)  Rio de Janeiro Rio de Janeiro Brazil"},{"name":"Instituto D'Or de Pesquisa e Ensino (IDOR)  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fl\u00e1via Ribeiro","family":"Machado","sequence":"additional","affiliation":[{"name":"Disciplina de Anestesiologia, Dor e Medicina Intensiva Universidade Federal de S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel de","family":"Andrade","sequence":"additional","affiliation":[{"name":"Central Estadual de Transplantes de Santa Catarina  Florian\u00f3polis Santa Catarina Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano Cesar Pontes","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Academic\u00a0Research\u00a0Organization Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Statistics, Universidade Federal do Rio Grande do Sul (UFRGS)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano Serpa","family":"Hammes","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento (HMV)  Porto Alegre Rio Grande do Sul Brazil"},{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias Pneumol\u00f3gicas Universidade Federal do Rio Grande do Sul (UFRGS)  Porto Alegre Rio Grande do Sul 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