Homeostasis of the early postoperative period in orthotopic liver transplantation in children

Abstract

Purpose An observational study was undertaken to identify diff erences in children ' s homeostasis in the early postoperative period after orthotopic liver transplantation (OLT) depending on the age. Materials and methods.We have compared the paraclinical parameters of children in the early postoperative period after OLT in the early postoperative period (up to 4 days). Selected groups: group 1-18 patients aged 2 to 11 months; group 2-13 patients older than 1 year. Observational study. Statistical processing by nonparametric criteria.Results. The identifi ed intergroup diff erences in homeostasis in the immediate postoperative period after OLT were determined mainly by the usual nuances of age-related physiological diff erences. In the children of the fi rst year of life, the functions of the donor liver made it possible to level the preoperative defi ciency in the synthesis of antithrombin-III, but this group demonstrated manifestations of the refeeding syndrome and intestinal motor dysfunction, which led to a prolongation of observation in the intensive care unit. The results obtained are reproducible in the most surgical hospitals. Conclusion.In the children of the fi rst year of life after orthotopic liver transplantation, the digestive and motor functions of the digestive tract are slowly restored, which necessitates prolonged epidural blockade, careful resumption of nutritional support, and prolonged observation in the intensive care unit. In the children older than 1 year, there was noticed a tendency to leukopenia, which increases the probability of infectious complications. No dangerous manifestations of acute renal injury were noted.