Pediatric Liver Transplantation

Devictor, Denis; Tissières, Pierre

doi:10.1007/978-1-4471-6359-6_29

Cited by 1 publication

(1 citation statement)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Orthotopic liver transplantation (LT) has become a standard therapy for end-stage liver disease in children. Over the past 30 years, the improvements in surgical techniques, immunosuppression, and perioperative intensive care management have improved survival and long-term outcome of patients with LT. 1 In recent years, pediatric LT has been progressing immensely in Mainland China. 2 But pediatric transplants are performed at large transplant centers, which mainly engage in adult transplantation, and no children's hospital is authorized to perform LT. Little communication between pediatricians and transplant surgeons is one of main problems that influence the outcome of LT in China.…”

Section: Instructionmentioning

confidence: 99%

Postoperative Risk Factors and Outcome of Patients With Liver Transplantation Who Were Admitted to Pediatric Intensive Care Unit: A 10-Year Single-Center Review in China

Qian

Qiu

Xiang

et al. 2019

J Intensive Care Med

View full text Add to dashboard Cite

Introduction: The aim of this study was to present our 10-year experience of pediatric intensive care unit (PICU) management with pediatric liver recipients and to understand the importance of close interdisciplinary cooperation in 2 hospitals. Methods: A retrospective chart review study was performed according to our hospital’s medical records and the pediatric liver transplant database of Renji hospital. Results: A total of 767 patients received liver transplantation (LT) performed in Renji hospital between October 2006 and December 2016, of which 97 of them were admitted to PICU in our center for various complications developed after transplantation. 8.8% (16/208) and 14.4% (81/559) of patients were transferred to PICU in stages I and II, respectively, and was comparable in the 2 stages ( P = .017). The majority of patients was late postoperative children (median 185 post-LT days) in stage I. More patients were transferred to PICU directly in stage II. PICU admitted more younger (median 8.2 months) and early postoperative patients in stage II. The median length of PICU stay was 11.0 (6.0-20.5) days. The median length of mechanical ventilation was 5.0 (0.0-12.0) days. The most frequent complications were pulmonary complications (52 [53.6%] patients), surgical complications (22 [22.7%] patients), sepsis (7 [7.2%]), and other miscellaneous complications (16 [16.5%] patients). The overall 28-day PICU mortality was 25.8% (n = 25) and 64.0% (n = 16) of the deaths happened in the early postoperative period. There was significant difference concerning mortality in children with surgical complications and medical problems (54.5% [12/22] vs 17.3% [13/75], P = .001). Multivariate analysis by regression showed that the pediatric risk of mortality III score was the only independent prognostic factor ( P = .031). Conclusions: Multiple complications occur in children with LT. Although challenging, interdisciplinary cooperation between different hospitals is an effective mean to enable children to maximize the benefit gained from LT in China.

show abstract

Section: Instructionmentioning

confidence: 99%