Abstract:
:Surgical techniques that have been used during liver transplantation (LT) together with patient's coagulation profile and institutional practices are reported to have an effect on transfusion requirements. The aim of this study is to evaluate the transfusion requirement in both cadaveric (CDLT, n = 22) and living donor (LDLT, n = 24) pediatric LT performed in our institution. Balanced general anesthesia was used for all patients. Transfusion requirements were met to maintain a hemoglobin concentration of 8-10 g/dL, platelet level >50 x 10(3)/mL, prothrombin time <20 s and hemodynamic course with observing heart rate, arterial and central venous blood pressures and hourly urine output. Blood loss was replaced by using whole blood. Both groups' perioperative total blood and fresh-frozen plasma (FFP) volumes transfused, fluid requirements and hemodynamic courses, standard coagulation profile and metabolic variables determined in time periods of operations, patients' preoperative characteristics, operative features and postoperative events were compared. The mean transfusion requirements were 37.1 +/- 33.4 and 74.8 +/- 90.8 mL/kg of whole blood (p = 0.059) and 34.5 +/- 24.9 and 51.5 +/- 59.7 mL/kg of FFP for CDLT and LDLT, respectively (p = 0.519). The mean ages and mean body weights of the CDLT patients were higher than LDLT patients (9.7 +/- 5.3 vs. 6.6 +/- 4.4 yr, p = 0.015 and 32.4 +/- 17.7 vs. 21.0 +/- 14.8 kg, p = 0.032, respectively) while the mean operation time (493 +/- 135 vs. 323 +/- 93 min, p = 0.0001) and PELD score (13.1 +/- 11.2 vs. 20.1 +/- 11.8, p = 0.036) were higher for LDLT. In the entire population, multiple regression analysis showed that age, body weight and operation time have a significant combined effect on blood consumption (r2= 0.29, p = 0.003) meanwhile operation time was found to be an effective single variable (p = 0.002). None of the single or combined variables was found to have a significant effect on FFP consumption (r2= 0.17, p = 0.63) and crystalloid use (r2= 0.19, p = 0.11). Hemodynamic courses of both groups were similar. The incidences of metabolic acidosis and hypothermia during the anhepatic periods were higher in the CDLT group (p < 0.05). However, transfusion requirement in the ICU were higher in LDLT group [6.9 +/- 2.2 (n = 6) vs. 18.6 +/- 19 (n = 11) mL/kg, p < 0.05] after LT. As a result of this study in a pediatric patient population, no statistical significance was found in whole blood transfusion and FFP requirements between CDLT and LDLT. Duration of the operation was the primary factor effecting transfusion volume showing the importance of continued small volume losses during uncomplicated LT in this small sized patient population. Transfusion need for pediatric LT should be individualized for each patient based on the intraoperative conditions including surgical and patient features.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Ulukaya S,Acar L,Ayanoglu HOdoi
10.1111/j.1399-3046.2005.00284.xkeywords:
subject
Has Abstractpub_date
2005-06-01 00:00:00pages
332-7issue
3eissn
1397-3142issn
1399-3046pii
PTR284journal_volume
9pub_type
杂志文章abstract::CVD is a major cause of morbidity and mortality in pediatric patients with CKD. It is unclear whether vascular abnormalities in these patients are reversible, and if transplantation portends salutary effects on arterial function. We compared FMD, PWV, AI75, and CIMT in 15 dialysis (D), 14 transplant patients (T), and ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2012.01721.x
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:Myeloablative conditioning before allogeneic HSCT during childhood exposes to serious long-term complications, especially gonadal dysfunction. Pubertal issues are less described than other post-HSCT sequelae in childhood. METHODS:Pubertal development and biological gonadal parameters were assessed in a re...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13773
更新日期:2020-09-01 00:00:00
abstract::PPCA has historically been considered detrimental to donor quality in LT, but transplantation of grafts from this group of donors is now routine. Our study aims to evaluate the outcomes associated with use of donors with a history of PPCA in the pediatric population. This study is a single-center retrospective analysi...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13701
更新日期:2020-08-01 00:00:00
abstract::Obscure gastrointestinal (GI) bleeding is defined as bleeding from the GI tract that persists or recurs, with no obvious etiology, after esophagogastroduodenoscopy (EGD), colonoscopy, and radiologic evaluation of the small bowel. We present the case of a 17-yr-old girl who for two years had been suffering from recurre...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2010.01425.x
更新日期:2012-05-01 00:00:00
abstract::Facial transplantation has become a reality in adult medicine. Children are subject to congenital craniofacial differences, disease-related, traumatic, or thermochemical craniofacial changes and might be suitable for face transplantation. This manuscript addresses unique ethical issues in considering potential pediatr...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13032
更新日期:2017-11-01 00:00:00
abstract::Knowledge concerning the involvement of the cardiovascular system in children awaiting liver transplant is limited. Therefore, no guidelines have been established on evaluating this group of patients for cardiac disease. This review examines the diverse cardiovascular manifestations of liver disease in children. We al...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-3046.2012.01667.x
更新日期:2012-06-01 00:00:00
abstract::The emergence of oseltamivir-resistant 2009 H1N1 influenza virus (conferred by the H275Y substitution in NA) during therapy or prophylaxis in immunocompromised patients is a serious concern. The optimal therapy for immunosuppressed patients with oseltamivir-resistant 2009 H1N1 influenza virus is unknown and few option...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2011.01489.x
更新日期:2012-08-01 00:00:00
abstract::Children receiving HCT loose protective immunity to vaccines received pre-HCT. Therefore, revaccination post-HCT is of major importance. In Denmark, a vaccination schedule with fewer doses post-HCT has been used, including two doses for diphtheria, tetanus, polio, measles, mumps, and rubella, and one dose only for Hae...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13599
更新日期:2020-02-01 00:00:00
abstract::Improving a patient's quality-of-life (QOL) post-liver transplantation is of great importance. An aspect of improved QOL is the restoration of normal growth patterns in pediatric patients. To describe the post-transplantation growth patterns of 72 children included in the National Institute of Diabetes and Digestive a...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2005.00326.x
更新日期:2005-08-01 00:00:00
abstract::LAD is a rare and fatal congenital disorder in which there is a defect of the leukocyte adhesion molecule (CD18) on neutrophils. Severe LAD results in frequent and potentially fatal infections. Although allogeneic HSCT is the only curative treatment for severe LAD, strategies for HSCT remain to be established since a ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00723.x
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Of the 600 pediatric candidates added to the liver waiting list annually, 100 will remain waiting while over 100 liver allografts are discarded, often for subjective reasons. METHODS:We created a risk index to predict discard to better optimize donor supply. We used the UNOS database to retrospectively anal...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13963
更新日期:2021-01-06 00:00:00
abstract::Effective antibody removal using PE, DFPP and IA has led to increased access to live donor organs through ABOi RT for patients with chronic kidney disease. However, there have been no head-to-head comparator studies between these modalities, and the choice of technique is usually influenced by cost and institutional p...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12227
更新日期:2014-05-01 00:00:00
abstract::Acute graft-versus-host disease (GVHD) is a common and serious complication of allogeneic blood and marrow transplantation. Acute GVHD is commonly graded according to modified Glucksberg criteria. There is considerable within-grade heterogeneity with different patterns of skin, liver, or gut involvement. In this comme...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.12433
更新日期:2015-05-01 00:00:00
abstract::Dysregulation of genes involved in the cell cycle such as TP53, P21, P16, and PTEN plays a key role in oncogenesis. We have earlier reported increased expression of the TP53 encoded protein p53, in bone marrow samples from pediatric patients with more aggressive, rare chronic myeloid malignancies. The aim of this stud...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12585
更新日期:2015-11-01 00:00:00
abstract::To evaluate social development of pediatric heart transplant (tx) recipients who have lived 15 or more years after transplantation. Among 498 pediatric patients, age less than 18 years, who underwent heart transplantation, at a single institution, 337 were performed between 1985 and 1998. We identified all who survive...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12853
更新日期:2017-03-01 00:00:00
abstract::Little has been studied regarding the diets of children following LTX. The study aim was to assess and compare dietary intake and DQ of healthy children and children post-LTX. Children and adolescents (2-18 years) post-LTX (n=27) and healthy children (n=28) were studied. Anthropometric and demographic data and two 24-...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12944
更新日期:2017-09-01 00:00:00
abstract::Early graft loss and poor graft function limit the use of kidneys from infant donors. Six en bloc kidney transplantations were performed from infant donors younger than 10 months into pediatric recipients between November 2012 and September 2015 at our center. We retrospectively analyzed recipient and donor demographi...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12845
更新日期:2017-03-01 00:00:00
abstract::RTx of adult-size kidneys presents a size mismatch in small pediatric recipients, and there are potential surgical complications. This study reveals the outcomes of intra- and extraperitoneal RTx in low-weight (less than 15 kg) pediatric recipients. We studied 51 pediatric patients weighing less than 15 kg who receive...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13401
更新日期:2019-06-01 00:00:00
abstract::The potentially curative role of allogeneic hematopoietic cell transplantation (HCT) in neoplastic and non-neoplastic diseases is offset by the substantial risks of morbidity and mortality from complications of the intensive myeloablative and immunosuppressive preparative regimen. These regimen-related toxicities have...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-3046.2003.00016.x
更新日期:2003-06-01 00:00:00
abstract::Bartter's syndrome (BS) is an incurable genetic disease, with variable response to supportive therapy relating to fluid and electrolyte management. Poor control or therapy non-compliance may result in frequent life threatening episodes of dehydration, acidosis and hypokalemia, with resultant adverse effects on patient...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2005.00435.x
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Urinary diversion using catheterizable channel among posterior urethral valve (PUV) patients may help to alleviate the functional concerns of the bladder on the allograft. Herein, we review our series of PUV patients undergoing renal transplants at a single institution to determine outcomes between those wit...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13798
更新日期:2020-12-01 00:00:00
abstract::Although TEG directs effective resuscitation in adult surgical patients, pediatric data are lacking. We performed a retrospective comparative review of the effect of TEG on blood product utilization and outcomes following pediatric liver transplantation in 38 patients between 2008 and 2014. Diagnoses, laboratory value...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13176
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Self-management for patients who have undergone solid organ transplantation is demanding and a challenge for adolescents transitioning into adult-oriented healthcare systems. This study explores whether adolescent and young adult solid organ transplant patients support the use of online peer support programs ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13900
更新日期:2020-11-01 00:00:00
abstract::In 1999, our center implemented a policy of outpatient protocol biopsies as standard practice for the clinical management of pediatric renal allograft recipients. In order to determine the safety of this procedure, we conducted a retrospective chart audit of all outpatient renal allograft biopsies performed at our cen...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2006.00659.x
更新日期:2007-03-01 00:00:00
abstract::The need for evidence-based practice guidelines requires high quality, carefully controlled clinical research trials. This multidisciplinary conference attempted to: identify urgent clinical and research issues, identify obstacles to performing clinical trials, develop concepts for organ-specific and all-organ researc...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00811.x
更新日期:2008-03-01 00:00:00
abstract::Delayed recovery of thrombocytopenia is a well-known complication after allogeneic HSCT. Eltrombopag (ELT), a thrombopoietin receptor agonist (TRAs), induces platelet maturation and release. Mostly conducted in adults, some of the previous studies have shown that ELT seems to enhance platelet recovery for post-allogen...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13962
更新日期:2021-01-16 00:00:00
abstract::Non-adherence to immunosuppressant medications is an important risk factor for graft dysfunction. To evaluate the effectiveness of adherence-enhancing interventions, we reviewed adherence intervention studies in solid organ transplant recipients (all ages). Using the following databases: PsycINFO, PubMed, Scopus, and ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.13086
更新日期:2018-02-01 00:00:00
abstract::Secondary failure of platelet engraftment occurs in 20% of patients undergoing allogeneic HSCT and is associated with poor outcome. Currently, there are no guidelines for treatment of late thrombocytopenia and platelet transfusion is the mainstay of treatment. Here, we describe the use of Eltrombopag to treat secondar...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13017
更新日期:2017-09-01 00:00:00
abstract::IHHE as the most common vascular tumor of the liver in infancy can present with acute postnatal liver and congestive heart failure. LTx may be a lifesaving option, but can be complicated by extrahepatic involvement and bleeding complications, especially in neonates. Here we discuss the benefit of LTx in cases of acute...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2008.01039.x
更新日期:2009-08-01 00:00:00
abstract::The indications for and the timing of LT and/or KT for the patients with HRFCD are based on the severity of liver and kidney involvement. Most organs come from living donors, because the number of deceased donors is extremely low in Japan. Therefore, patients with HRFCD may need two organs from living donors. Four pat...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2011.01609.x
更新日期:2012-02-01 00:00:00