Risk factors for postreperfusion syndrome during living donor liver transplantation in pediatric patients with biliary atresia
10.3760/cma.j.cn131073.20230409.00906
- VernacularTitle:胆道闭锁患儿活体肝移植术中再灌注综合征的危险因素
- Author:
Yuli WU
1
;
Yiqi WENG
;
Yongle JING
;
Tianying LI
;
Lu CHE
;
Mingwei SHENG
;
Lili JIA
;
Weihua LIU
;
Wenli YU
Author Information
1. 天津市第一中心医院麻醉科，天津 300192
- Keywords:
Child;
Liver transplantation;
Biliary atresia;
Postreperfusion syndrome
- From:
Chinese Journal of Anesthesiology
2023;43(9):1054-1058
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for postreperfusion syndrome (PRS) during living donor liver transplantation in pediatric patients with biliary atresia.Methods:The clinical data from pediatric patients who underwent living donor liver transplantation from January 2020 to December 2021 in our hospital were retrospectively analyzed. The clinical data included: (1) general information of the pediatric patients such as age, gender, height and body weight; (2) preoperative data such as left ventricular ejection fraction, pediatric end-stage liver disease score, serum aminotransferase, aspartate aminotransferase, total bilirubin, International Normalised Ratio and creatinine concentrations, and whole blood Hb concentration; (3) intraoperative data such as vital signs and blood gas analysis parameters immediate before reperfusion, time of anhepatic phase, donor liver cold ischemia time, transplanted liver quality, time of surgery, anesthesia time, volume of urine, blood loss, amount of blood transfused, and amount of fresh frozen plasma transfused. The pediatric patients were divided into PRS group and non-PRS group according to whether intraoperative PRS occurred. Risk factors for PRS were analyzed using binary logistic regression analysis.Results:A total of 304 pediatric patients were finally enrolled, with 132 cases in PRS group and 172 cases in non-PRS group. The incidence of PRS was 43.4%. The results of logistic regression analysis showed that prolonged liver graft cold ischemic time ( OR=1.031, 95% confidence interval 1.021-1.042, P<0.001) and body temperature <36 ℃ immediately before reperfusion ( OR=3.095, 95% confidence interval 1.656-5.785, P<0.001) were risk factors for PRS. Conclusions:Body temperature immediately before reperfusion<36.0 ℃ and prolonged liver graft cold ischemic time are risk factors for PRS during living donor liver transplantation in pediatric patients with biliary atresia.
