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Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study

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单位: [1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China [2]Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China [3]Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing, P.R. China
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关键词: Hemodynamics Intraoperative Complications Liver Transplantation Pediatrics Risk Factors

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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.

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出版当年[2017]版:
大类 | 4 区 医学
小类 | 4 区 外科 4 区 移植
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 外科 4 区 移植
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出版当年[2016]版:
Q3 SURGERY Q4 TRANSPLANTATION
最新[2023]版:
Q3 SURGERY Q3 TRANSPLANTATION

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2016版] 出版当年五年平均[2012-2016] 出版前一年[2015版] 出版后一年[2017版]

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第一作者单位: [1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
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