单位:[1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China临床科室麻醉科麻醉科首都医科大学附属北京友谊医院[2]Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China临床科室国家中心普外分中心普外四科(肝脏移植外科)首都医科大学附属北京友谊医院[3]Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing, P.R. China临床科室国家中心普外分中心普外四科(肝脏移植外科)首都医科大学附属北京友谊医院
Background: Postreperfusion syndrome (PRS) is a dreadful and well-documented complication in adult liver transplantation (LT). However, information regarding PRS in pediatric LT is still scarce. We aimed to identify the incidence, risk factors and associated outcomes of pediatric LT in a single-center study. Material/Methods: The medical records of 75 consecutive pediatric patients who underwent deceased donor liver transplantation (DDLT) from July 2015 to October 2017 were retrospectively reviewed. PRS was determined according to the Peking criteria when significant arrhythmia or refractory hypotension occurred following revascularization of the liver graft. Patients were divided into PRS and non-PRS groups. Preoperative, intraoperative, and postoperative data were collected and compared between the 2 groups. Independent risk factors for PRS were analyzed using binary logistic regression analysis. Results: PRS occurred in 26 patients (34.7%). Univariate analysis showed that the graft-to-recipient weight ratio (P=0.023), donor warm ischemia time (P<0.001), and the use of an expanded criteria donor (ECD) liver graft (P<0.001) were significant predictors of PRS. Binary logistic regression showed that the use of an ECD liver graft (odds ratio [OR]: 18.668; 95% confidence interval [95% CI]: 4.866-71.622) and lower hematocrit (HCT) level before reperfusion (OR: 0.878; 95% CI: 0.782-0.985) were independent predictors of PRS. PRS was significantly associated with early allograft dysfunction (73.1% vs. 18.4%, P<0.001), primary nonfunction (11.5% vs. 0.0%, P=0.039), and a prolonged hospital stay (median: 30.5 vs. 21.0, P=0.007). Conclusions: The use of an ECD liver graft and lower HCT level before reperfusion were independent risk factors for PRS in pediatric DDLT. Intraoperative PRS occurrence seems to be associated with poor liver allograft function and worsened patient postoperative outcomes.
基金:
Capital Special Program for Health Research and Development [2016-1-2021]; Scientific Research Key Program of Beijing Municipal Commission of EducationBeijing Municipal Commission of Education [KZ201510025026]
第一作者单位:[1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
通讯作者:
推荐引用方式(GB/T 7714):
Liang Zhang,Ming Tian,Fushan Xue,et al.Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study[J].ANNALS of TRANSPLANTATION.2018,23:334-344.doi:10.12659/AOT.909050.
APA:
Liang Zhang,Ming Tian,Fushan Xue&Zhijun Zhu.(2018).Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study.ANNALS of TRANSPLANTATION,23,
MLA:
Liang Zhang,et al."Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study".ANNALS of TRANSPLANTATION 23.(2018):334-344