02 September 2013 : Original article
Predictive factors for pediatric patients requiring massive blood transfusion during living donor liver transplantation
Chia-Jung HuangABCDEF, Kwok-Wai ChengBC, Chao-Long ChenAB, Shao-Chun WuBCD, Tsung-Hsiao ShihBC, Sheng-Chun YangBC, Bruno JawanABCDE, Chih-Hsien WangABCDEFDOI: 10.12659/AOT.889293
Ann Transplant 2013; 18:443-447
Abstract
BACKGROUND: The aim of this study was to identify the preoperative risk factors that may predict the requirement of massive blood transfusion during pediatric living donor liver transplantation.
MATERIAL AND METHODS: The anesthesia charts of pediatric patients undergoing living donor liver transplantation were reviewed retrospectively. Patients were grouped into 2 categories based on the amount of intraoperative blood transfusion. Group I (GI) consists of patients who received massive blood transfusion and Group II (GII) consists of patients who did not receive massive blood transfusion. The patients’ characteristics and preoperative data were compared between groups with the Mann-Whitney U test. Predictive risk factors for massive blood transfusion were analyzed by binary regression. A p value of <0.05 was regarded as significant. Data are given as mean ±SD.
RESULTS: A total of 198 pediatric patients were included in this study. Thirteen (6.5%) of the 198 pediatric patients undergoing living donor liver transplantation met the criteria of massive blood transfusion. The mean estimated blood volume of GI and GII was 724±322 and 1097±830 ml, respectively. The mean quantity of blood products given were 1018±591 and 187±220 ml for GI and GII, respectively. RBC was given to 67% of the patients, FFP was given to 18%, and only 1% received platelet transfusion. The patients who required massive blood transfusion were younger in age and had smaller body size, with prolonged INR (international normalized ratio) observed. INR, a measure of blood clotting time, was the only predictive factor that can impact intraoperative massive blood loss and subsequent blood transfusion. Each prolongation of 0.1 unit of INR elevates by 1.083-fold the risk of massive blood transfusion (95% C.I.=1.030–1.139, P=0.002).
CONCLUSIONS: Preoperative INR was the only predictive risk factor for massive blood transfusion during pediatric living donor liver transplantation. Increasing the ratio of FFP transfusion in patients with prolonged INR before or during pediatric LDLT is recommended.
Keywords: Predictive factor, end-stage liver disease, living donor liver transplantation, Pediatric, general anesthesia, massive blood transfusion
SARS-CoV-2/COVID-19
17 June 2022 : Case report
Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature ReviewAnn Transplant In Press; DOI: 10.12659/AOT.935874
12 April 2022 : Letter/Correspondence
Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...Ann Transplant 2022; 27:e935863
12 November 2021 : Original article
Coronavirus Disease 2019 (COVID-19) in Solid Organ Transplant Recipients: A Case-Control StudyAnn Transplant 2021; 26:e933152
26 October 2021 : Original article
Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 PandemicAnn Transplant 2021; 26:e933001
In Press
23 Jun 2022 : Original article
Evaluation of Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program in Comparison to S...Ann Transplant In Press; DOI: 10.12659/AOT.936514
21 Jun 2022 : Case report
Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature ReviewAnn Transplant In Press; DOI: 10.12659/AOT.935874
20 Jun 2022 : Original article
The Association Between Tacrolimus Levels and Hyperkalemia in Allograft Recipients Who Underwent Heart or L...Ann Transplant In Press; DOI: 10.12659/AOT.935607
15 Jun 2022 : Original article
Donor CYP3A5 Expression Decreases Renal Transplantation Outcomes in White Renal Transplant RecipientsAnn Transplant In Press; DOI: 10.12659/AOT.936276
Most Viewed Current Articles
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :10.12659/AOT.934924
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original article
Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...DOI :10.12659/AOT.933588
Ann Transplant 2021; 26:e933588
24 Jul 2020 : Review article
Kidney Transplantation in the Times of COVID-19 – A Literature ReviewDOI :10.12659/AOT.925755
Ann Transplant 2020; 25:e925755
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860