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Preoperative risk factors for intra‐operative bleeding in pediatric liver transplantation
Author(s) -
Fanna Martina,
Baptiste Amandine,
Capito Carmen,
Ortego Rocio,
Pacifico Raffaella,
Lesage Fabrice,
Moulin Florence,
Debray Dominique,
Sissaoui Samira,
Girard Muriel,
Lacaille Florence,
Telion Caroline,
Elie Caroline,
Aigrain Yves,
Chardot Christophe
Publication year - 2016
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12794
Subject(s) - medicine , liver transplantation , surgery , transplantation , preoperative care
This study analyzes the preoperative risk factors for intra‐operative bleeding in our recent series of pediatric LT s. Between November 2009 and November 2014, 84 consecutive isolated pediatric LT s were performed in 81 children. Potential preoperative predictive factors for bleeding, amount of intra‐operative transfusions, postoperative course, and outcome were recorded. Cutoff point for intra‐operative HBL was defined as intra‐operative RBC transfusions ≥1 TBV. Twenty‐six patients (31%) had intra‐operative HBL . One‐year patient survival after LT was 66.7% ( CI 95%=[50.2–88.5]) in HBL patients and 83.8% ( CI 95%=[74.6–94.1]) in the others ( P =.054). Among 13 potential preoperative risk factors, three of them were identified as independent predictors of high intra‐operative bleeding: abdominal surgical procedure(s) prior to LT, factor V level ≤30% before transplantation, and ex situ parenchymal transsection of the liver graft. Based on these findings, we propose a simple score to predict the individual hemorrhagic risk related to each patient and graft association. This score may help to better anticipate intra‐operative bleeding and improve patient's management.