Objective·To monitor postoperative blood glucose(BG)and blood lipids(BL)at multiple time points in pediatric patients undergoing liver transplantation(LT)and to analyze the influencing factors.Methods·An observational study was conducted,including pediatric LT patients from the Hepatic Surgery Department of Renji Hospital,Shanghai Jiao Tong University School of Medicine.Blood samples were collected one day before surgery and on days 1,7,and 14 after surgery.Basic patient information and laboratory indicators were recorded,including complete blood count(CBC),cytochrome P450(CYP)genotyping,tacrolimus dosage(TD),tacrolimus serum drug level(TSDL),fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG),and biochemical testing for liver transplantation(BTLT).BTLT included the following indicators:total protein(TP),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(AKP),transglutaminase(GGT),direct bilirubin(DBil),total bilirubin(TBil),creatinine(Cr),triglyceride(TAG),total cholesterol(TC),prothrombin time(PT),and international normalized ratio(INR).The t-test or Mann-Whitney U test was used to analyze factors influencing PBG,Cox regression analysis was used to analyze factors influencing FBG,and logistic regression analysis was used to analyze factors influencing TC.Results·A total of 82 pediatric LT patients were included,with 45 males(54.9%)and 37 females(45.1%).The average age was 7 months,average height was 65 cm,and average body weight was 7.15 kg.FBG[(6.54±1.71)mmol/L]and PBG[(7.42±2.19)mmol/L]reached their highest values on the first postoperative day and gradually decreased to normal levels.There were 59 patients in the normal FBG and PBG groups and 23 in the abnormal groups.TAG[(0.93±0.63)mmol/L]and TC[(1.91±1.08)mmol/L]reached their lowest values on the first postoperative day and then slowly increased.The t-test indicated that TP(P=0.050),AKP(P=0.020),GGT(P=0.002),TC(P=0.017),and TD(P=0.028)showed statistically significant differences between the normal and abnormal PBG groups.Cox regression analysis showed that gender(HR=0.501,95%CI 0.184?1.361),age(HR=0.972,95%CI 0.876?1.079),height(HR=1.012,95%CI 0.903?1.135),body weight(HR=1.067,95%CI 0.720?1.579),and blood type(A type HR=1.294,95%CI 0.464?3.612;B type HR=1.303,95%CI 0.456?3.723;AB type HR=1.520,95%CI 0.310?7.441)did not significantly affect the BG's time change process.Logistic regression analysis showed that the patient's CYP(1×3 OR=9.332,95%CI 0.960?90.719;3×3 OR=18.083,95%CI 1.414?231.219)was a factor influencing TC.Conclusion·TD is a factor influencing PBG on the first postoperative day,and the patient's CYP is a factor influencing TC on the same day.

Objective·To monitor postoperative blood glucose(BG)and blood lipids(BL)at multiple time points in pediatric patients undergoing liver transplantation(LT)and to analyze the influencing factors.Methods·An observational study was conducted,including pediatric LT patients from the Hepatic Surgery Department of Renji Hospital,Shanghai Jiao Tong University School of Medicine.Blood samples were collected one day before surgery and on days 1,7,and 14 after surgery.Basic patient information and laboratory indicators were recorded,including complete blood count(CBC),cytochrome P450(CYP)genotyping,tacrolimus dosage(TD),tacrolimus serum drug level(TSDL),fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG),and biochemical testing for liver transplantation(BTLT).BTLT included the following indicators:total protein(TP),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(AKP),transglutaminase(GGT),direct bilirubin(DBil),total bilirubin(TBil),creatinine(Cr),triglyceride(TAG),total cholesterol(TC),prothrombin time(PT),and international normalized ratio(INR).The t-test or Mann-Whitney U test was used to analyze factors influencing PBG,Cox regression analysis was used to analyze factors influencing FBG,and logistic regression analysis was used to analyze factors influencing TC.Results·A total of 82 pediatric LT patients were included,with 45 males(54.9%)and 37 females(45.1%).The average age was 7 months,average height was 65 cm,and average body weight was 7.15 kg.FBG[(6.54±1.71)mmol/L]and PBG[(7.42±2.19)mmol/L]reached their highest values on the first postoperative day and gradually decreased to normal levels.There were 59 patients in the normal FBG and PBG groups and 23 in the abnormal groups.TAG[(0.93±0.63)mmol/L]and TC[(1.91±1.08)mmol/L]reached their lowest values on the first postoperative day and then slowly increased.The t-test indicated that TP(P=0.050),AKP(P=0.020),GGT(P=0.002),TC(P=0.017),and TD(P=0.028)showed statistically significant differences between the normal and abnormal PBG groups.Cox regression analysis showed that gender(HR=0.501,95%CI 0.184?1.361),age(HR=0.972,95%CI 0.876?1.079),height(HR=1.012,95%CI 0.903?1.135),body weight(HR=1.067,95%CI 0.720?1.579),and blood type(A type HR=1.294,95%CI 0.464?3.612;B type HR=1.303,95%CI 0.456?3.723;AB type HR=1.520,95%CI 0.310?7.441)did not significantly affect the BG's time change process.Logistic regression analysis showed that the patient's CYP(1×3 OR=9.332,95%CI 0.960?90.719;3×3 OR=18.083,95%CI 1.414?231.219)was a factor influencing TC.Conclusion·TD is a factor influencing PBG on the first postoperative day,and the patient's CYP is a factor influencing TC on the same day.

Objective To explore the risk factors for the returning of pediatric liver transplant recipi-ents to the intensive care unit(ICU)and provide reference for the clinical decision-making after surgery.Methods A retrospective analysis was conducted with the information of all the pediatric patients who underwent liver transplantation in Ren Ji Hospital,Shanghai Jiao Tong University School of Medicine and were returned to the ICU from 2019 to 2021.The patients returned to the ICU during hospitalization and the reasons for the return were recorded.Each patient of ICU return was matched with three pediatric patients who did not return to the ICU during hospitalization.The basic information,the vital signs and laboratory indicators on the day of transfer from ICU,immunosuppressants and drug concentrations were compared between the two groups.Multivariate Logistic regression analysis was performed to explore the risk factors for the returning of pediatric liver transplant recipients to the ICU.Results The returning rate of pediatric liver transplant recipients to the ICU was 4.36％,and it was 16.00％within 48 h.The main reasons for the return included respiratory complications,abdominal infections,and hepatic vascular occlusion.Multivariate Logistic regression analysis showed that post-operative red blood cell transfusion(OR=4.554,95％CI=1.743-11.901,P=0.002)and high serum level of uric acid(OR=1.005,95％CI=1.001-1.009,P=0.014)were the risk factors for returning to the ICU.High diastolic blood pressure(OR=0.922,95％CI=0.885-0.960,P＜0.001)and high total protein level(OR=0.937,95％CI=0.891-0.986,P=0.012)were the protective factors for returning to the ICU.Conclusion Post-operative red blood cell transfusion and high serum level of uric acid are independent risk factors for the returning of pediatric liver transplant recipients to the ICU.

Objective: We observed the effect of the opening and closing pressure sensors on the pediatric liver transplantation. Methods: The 100 cases of pediatric patients who suffered biliary atresia were chose to this study from July 1^st 2018 to Dec 31^st 2018. They received the living donor liver transplantation. The samples were divided into control group and test group according to the random number table. We observed the volume of blood lost during the process of blood sample collecting. The hemoglobin (HB) and infection rate of catheter were also recorded. Results: The test group didn′t lose blood when collecting the sample, and the time of collecting the blood sample in the test group was (22.0 ± 4.2) s, which was shorter than that of in the control group (47.0 ± 7.8) s, the difference was significant, t=9.321, P<0.05. The difference of HB and infection rate of catheter after 24 hours between two groups was not significant, P>0.05. Conclusion The closing pressure sensor may be more advanced when used to avoid the loss of blood and prevent the infection.

Objective To survey the parents′satisfaction of clinical decision who have children with end-staged liver diseases. Methods The Questionnaire of Satisfaction of Clinical Decision was used as the instrument. Results The parents′satisfaction score 3 months after the surgery was (71.2 ±3.5) points, while 1 year after the surgery was (68.3±4.4) points, and the difference between them was not statistically, P value was more than 0.05. Besides, the satisfaction showed significant difference on the factors of education and monthly income. F values were 5.258 and 6.328, and P values were both less than 0.05. The stronger the education background was, the higher the satisfaction was. And so the monthly income was. Conclusions The parents have higher satisfaction of clinical decision, and the education and monthly income are the factors affecting the satisfaction.