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Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis

Background: Pediatric liver transplantation (LT) is strongly associated with increased intraoperative blood transfusion requirement and postoperative morbidity and mortality. In the present study, we aimed to assess the risk factors associated with massive transfusion in pediatric LT, and examined t...

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Autores principales: Jin, Seok-Joon, Kim, Sun-Key, Choi, Seong-Soo, Kang, Keum Nae, Rhyu, Chang Joon, Hwang, Shin, Lee, Sung-Gyu, Namgoong, Jung-Man, Kim, Young-Kug
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ivyspring International Publisher 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332847/
https://www.ncbi.nlm.nih.gov/pubmed/28260994
http://dx.doi.org/10.7150/ijms.17502
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author Jin, Seok-Joon
Kim, Sun-Key
Choi, Seong-Soo
Kang, Keum Nae
Rhyu, Chang Joon
Hwang, Shin
Lee, Sung-Gyu
Namgoong, Jung-Man
Kim, Young-Kug
author_facet Jin, Seok-Joon
Kim, Sun-Key
Choi, Seong-Soo
Kang, Keum Nae
Rhyu, Chang Joon
Hwang, Shin
Lee, Sung-Gyu
Namgoong, Jung-Man
Kim, Young-Kug
author_sort Jin, Seok-Joon
collection PubMed
description Background: Pediatric liver transplantation (LT) is strongly associated with increased intraoperative blood transfusion requirement and postoperative morbidity and mortality. In the present study, we aimed to assess the risk factors associated with massive transfusion in pediatric LT, and examined the effect of massive transfusion on the postoperative outcomes. Methods: We enrolled pediatric patients who underwent LT between December 1994 and June 2015. Massive transfusion was defined as the administration of red blood cells ≥100% of the total blood volume during LT. The cases of pediatric LT were assigned to the massive transfusion or no-massive transfusion (administration of red blood cells <100% of the total blood volume during LT) group. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors associated with massive transfusion in pediatric LT. Kaplan-Meier survival analysis, with the log rank test, was used to compare graft and patient survival within 6 months after pediatric LT between the 2 groups. Results: The total number of LT was 112 (45.0%) and 137 (55.0%) in the no-massive transfusion and massive transfusion groups, respectively. Multivariate logistic regression analysis indicated that high white blood cell (WBC) count, low platelet count, and cadaveric donors were significant predictive factors of massive transfusion during pediatric LT. The graft failure rate within 6 months in the massive transfusion group tended to be higher than that in the no-massive transfusion group (6.6% vs. 1.8%, P = 0.068). However, the patient mortality rate within 6 months did not differ significantly between the massive transfusion and no-massive transfusion groups (7.3% vs. 7.1%, P = 0.964). Conclusion: Massive transfusion during pediatric LT is significantly associated with a high WBC count, low platelet count, and cadaveric donor. This finding can provide a better understanding of perioperative blood transfusion management in pediatric LT recipients.
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spelling pubmed-53328472017-03-03 Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis Jin, Seok-Joon Kim, Sun-Key Choi, Seong-Soo Kang, Keum Nae Rhyu, Chang Joon Hwang, Shin Lee, Sung-Gyu Namgoong, Jung-Man Kim, Young-Kug Int J Med Sci Research Paper Background: Pediatric liver transplantation (LT) is strongly associated with increased intraoperative blood transfusion requirement and postoperative morbidity and mortality. In the present study, we aimed to assess the risk factors associated with massive transfusion in pediatric LT, and examined the effect of massive transfusion on the postoperative outcomes. Methods: We enrolled pediatric patients who underwent LT between December 1994 and June 2015. Massive transfusion was defined as the administration of red blood cells ≥100% of the total blood volume during LT. The cases of pediatric LT were assigned to the massive transfusion or no-massive transfusion (administration of red blood cells <100% of the total blood volume during LT) group. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors associated with massive transfusion in pediatric LT. Kaplan-Meier survival analysis, with the log rank test, was used to compare graft and patient survival within 6 months after pediatric LT between the 2 groups. Results: The total number of LT was 112 (45.0%) and 137 (55.0%) in the no-massive transfusion and massive transfusion groups, respectively. Multivariate logistic regression analysis indicated that high white blood cell (WBC) count, low platelet count, and cadaveric donors were significant predictive factors of massive transfusion during pediatric LT. The graft failure rate within 6 months in the massive transfusion group tended to be higher than that in the no-massive transfusion group (6.6% vs. 1.8%, P = 0.068). However, the patient mortality rate within 6 months did not differ significantly between the massive transfusion and no-massive transfusion groups (7.3% vs. 7.1%, P = 0.964). Conclusion: Massive transfusion during pediatric LT is significantly associated with a high WBC count, low platelet count, and cadaveric donor. This finding can provide a better understanding of perioperative blood transfusion management in pediatric LT recipients. Ivyspring International Publisher 2017-02-08 /pmc/articles/PMC5332847/ /pubmed/28260994 http://dx.doi.org/10.7150/ijms.17502 Text en © Ivyspring International Publisher This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
spellingShingle Research Paper
Jin, Seok-Joon
Kim, Sun-Key
Choi, Seong-Soo
Kang, Keum Nae
Rhyu, Chang Joon
Hwang, Shin
Lee, Sung-Gyu
Namgoong, Jung-Man
Kim, Young-Kug
Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
title Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
title_full Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
title_fullStr Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
title_full_unstemmed Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
title_short Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
title_sort risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332847/
https://www.ncbi.nlm.nih.gov/pubmed/28260994
http://dx.doi.org/10.7150/ijms.17502
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