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Intraoperative blood loss and transfusion during primary pediatric liver transplantation: A single‐center experience
Author(s) -
Villarreal Joshua A.,
Yoeli Dor,
Ackah Ruth L.,
Sigireddi Rohini R.,
Yoeli Jordan K.,
Kueht Michael L.,
Galvan N Thao N.,
Cotton Ronald T.,
Rana Abbas,
O’Mahony Christine A.,
Goss John A.
Publication year - 2019
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.13449
Subject(s) - medicine , cryoprecipitate , interquartile range , surgery , risk factor , blood transfusion , single center , transplantation , liver transplantation , coagulopathy , blood product , platelet
Children undergoing liver transplantation are at a significant risk for intraoperative hemorrhage and thrombotic complications, we aim to identify novel risk factors for massive intraoperative blood loss and transfusion in PLT recipients and describe its impact on graft survival and hospital LOS. We reviewed all primary PLTs performed at our institution between September 2007 and September 2016. Data are presented as n (%) or median (interquartile range). EBL was standardized by weight. Massive EBL and MT were defined as greater than the 85th percentile of the cohort. 250 transplantations were performed during the study period. 38 (15%) recipients had massive EBL, and LOS was 31.5 (15‐58) days compared to 11 (7‐21) days among those without massive EBL ( P < 0.001). MT median LOS was 34 (14‐59) days compared to 11 (7‐21) days among those without MT ( P = 0.001). Upon backward stepwise regression, technical variant graft, operative time, and transfusion of FFP, platelet, and/or cryoprecipitate were significant independent risk factors for massive EBL and MT, while admission from home was a protective factor. Recipient weight was a significant independent risk factor for MT alone. Massive EBL and MT were not statistically significant for overall graft survival. MT was, however, a significant risk factor for 30‐day graft loss. PLT recipients with massive EBL or MT had significantly longer LOS and increased 30‐day graft loss in patients who required MT. We identified longer operative time and technical variant graft were significant independent risk factors for massive EBL and MT, while being admitted from home was a protective factor.