Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

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 WangABCDEF

DOI: 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

Add Comment 0 Comments

In Press

08 Mar 2024 : Original article  

Association of Coronary Calcium Score on Cardiac PET During Pre-Kidney Transplant Assessment with Persisten...

Ann Transplant In Press; DOI: 10.12659/AOT.943532  

14 Mar 2024 : Original article  

Impact of Blood Products Transfusion on Patients in the Immediate Post-Lung Transplant Period: A Cohort Study

Ann Transplant In Press; DOI: 10.12659/AOT.943652  

14 Mar 2024 : Case report  

Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo ...

Ann Transplant In Press; DOI: 10.12659/AOT.942358  

15 Mar 2024 : Review article  

Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighti...

Ann Transplant In Press; DOI: 10.12659/AOT.941185  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

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

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358