Anesthetic management in pediatric liver transplantation: a comparison of deceased or live donor liver transplantations

Alper, Işık; Ulukaya, Sezgin

doi:10.1007/s00540-010-0928-z

Cited by 10 publications

(7 citation statements)

References 22 publications

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“…Importantly, PICU and total LOS have been reduced in patients who had IE, [10][11][12][13]25,26 reinforcing that this should be strongly considered for all pediatric recipients as long as they meet clinical criteria for IE. Postoperative analgesia was not emphasized on most of the case series, and it seems that many centers still rely on i.v.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, many centers routinely perform TEA in this setting, reporting successful IE rate in up to 80% of children. 4,7 Similarly, IE after pediatric liver transplantation has been considered a primary goal by many anesthesiologists, and a satisfactory IE rate has been achieved in some specialized pediatric liver centers, [10][11][12]25,26 ranging from 40% to more than 70%. Ulukaya et al 13 were the first to report IE in this setting.…”

Section: Discussionmentioning

confidence: 99%

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Thoracic epidural analgesia and immediate extubation for less than 10 kg infants undergoing living donor liver transplantation: A report of two successful cases

Díaz

Gouvêa

Spiller³

et al. 2022

Pediatric Transplantation

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Background Perioperative pain management in small infants weighing <10 kg undergoing liver transplantation is challenging. The use of TEA in this setting has not been reported, as well as its potential role to facilitate IE, ie, in the OR. Methods We describe here the use of TEA in two small infants who had IE after a LDLT procedure. Results TEA was successfully performed and IE was achieved in both cases. Postoperative analgesia assessment in the OR was satisfactory according to the FLACC pain scale, with scores of 2 and 3 for each patient, respectively. There were no major complications in the postoperative period, and the two children were discharged home uneventfully. Conclusions The use of TEA and its influence on IE rate and other perioperative outcomes should be more explored in small infants undergoing LDLT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thoracic epidural analgesia and immediate extubation for less than 10 kg infants undergoing living donor liver transplantation: A report of two successful cases

Díaz

Gouvêa

Spiller³

et al. 2022

Pediatric Transplantation

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“…There has been 1 previous study that associated the occurrence of PRS with preoperative hemoglobin level in adult LT [ 19 ]. Generally, most transfusion guidelines [ 27 – 29 ] in pediatric LT have recommended that the intraoperative HCT level should be maintained between 25% and 30% to minimize risks for HAT and transfusion-related complications. Our findings are important and cautionary because no previous studies have focused on the adverse effects of a restricted RBC transfusion on PRS.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study

et al. 2018

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BackgroundPostreperfusion syndrome (PRS) is a dreadful and well-documented complication in adult liver transplantation (LT). However, information regarding PRS in pediatric LT is still scarce. We aimed to identify the incidence, risk factors and associated outcomes of pediatric LT in a single-center study.Material/MethodsThe medical records of 75 consecutive pediatric patients who underwent deceased donor liver transplantation (DDLT) from July 2015 to October 2017 were retrospectively reviewed. PRS was determined according to the Peking criteria when significant arrhythmia or refractory hypotension occurred following revascularization of the liver graft. Patients were divided into PRS and non-PRS groups. Preoperative, intraoperative, and postoperative data were collected and compared between the 2 groups. Independent risk factors for PRS were analyzed using binary logistic regression analysis.ResultsPRS occurred in 26 patients (34.7%). Univariate analysis showed that the graft-to-recipient weight ratio (P=0.023), donor warm ischemia time (P<0.001), and the use of an expanded criteria donor (ECD) liver graft (P<0.001) were significant predictors of PRS. Binary logistic regression showed that the use of an ECD liver graft (odds ratio [OR]: 18.668; 95% confidence interval [95% CI]: 4.866–71.622) and lower hematocrit (HCT) level before reperfusion (OR: 0.878; 95% CI: 0.782–0.985) were independent predictors of PRS. PRS was significantly associated with early allograft dysfunction (73.1% vs. 18.4%, P<0.001), primary nonfunction (11.5% vs. 0.0%, P=0.039), and a prolonged hospital stay (median: 30.5 vs. 21.0, P=0.007).ConclusionsThe use of an ECD liver graft and lower HCT level before reperfusion were independent risk factors for PRS in pediatric DDLT. Intraoperative PRS occurrence seems to be associated with poor liver allograft function and worsened patient postoperative outcomes.

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“…Among the paediatric patients, LDLT is associated with longer operation times and higher RBC and fluid requirements than cadveric donor transplants. [6]…”

Section: Discussionmentioning

confidence: 99%

Successful living donor liver transplant in a very small child

Kumar

Raina

2010

Indian J Anaesth

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Anesthetic management in pediatric liver transplantation: a comparison of deceased or live donor liver transplantations

Cited by 10 publications

References 22 publications

Thoracic epidural analgesia and immediate extubation for less than 10 kg infants undergoing living donor liver transplantation: A report of two successful cases

Thoracic epidural analgesia and immediate extubation for less than 10 kg infants undergoing living donor liver transplantation: A report of two successful cases

Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study

Successful living donor liver transplant in a very small child

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