Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 23;51(1):41-47.
doi: 10.1159/000530290. eCollection 2024 Feb.

The Ratio of Intraoperative Red Blood Cell Transfusion to Blood Loss Associated with Early Postoperative Complications in Pediatric Liver Transplantation Patients

Yiming Ma  1 , Cheng Li  2 , Liying Sun  3   4   5 , Xiaofei Li  1
Affiliations

The Ratio of Intraoperative Red Blood Cell Transfusion to Blood Loss Associated with Early Postoperative Complications in Pediatric Liver Transplantation Patients

Yiming Ma et al. Transfus Med Hemother. .

Abstract

Introduction: Liver transplantation (LT) is an operation purposed to save the lives of children with acute or chronic liver diseases, hepatic tumors, and some genetic and metabolic diseases. However, patients who underwent LT have a significant risk of intraoperative blood loss and red blood cell (RBC) transfusion, especially in pediatric patients.

Methods: In this study, 569 pediatric patients (<18 years old) who underwent LT at a tertiary university hospital between 2013 and 2020 were included. Multiple logistic regression was used to analyze the association between the ratio of intraoperative RBC transfusion to blood loss (IRTBL) and the complications after LT in pediatric patients. IRTBL was divided into quartiles in the adjusted model. Odds ratios, 95% confidence intervals, and p values for trends were calculated. Restricted cubic spline (RCS) regression was used to evaluate the nonlinear association between IRTBL and complications.

Results: Compared with the lowest level and the highest level of IRTBL, Q2 and Q3 quartiles of IRTBL showed significantly positive association with early complications. A significantly nonlinear association was observed between the IRTBL and early complications in the RCS model with the multiple adjustments of potential covariates (P overall<0.01, P nonlinear<0.01). However, no significant association was observed between late complications and IRTBL.

Conclusion: In this study, we found there was a nonlinear relationship between the ratio of IRTBL and early postoperative complications in pediatric LT patients, which provides a theoretical basis for RBC transfusion in pediatric LT patients.

Keywords: Blood loss; Early postoperative complications; Intraoperative red blood cell transfusion to blood loss; Pediatric liver transplantation; Red blood cell transfusion.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1.
Fig. 1.
Flow diagram.
Fig. 2.
Fig. 2.
Classification and rank of early complications (a) and late complications (b).
Fig. 3.
Fig. 3.
Nonlinear association between IRTBL and complications among pediatric patients with LT in the RCS model. Nonlinear association between IRTBL and early complications (a) and nonlinear association between IRTBL and early complications among pediatric patients with LT (b). RCS models were adjusted by age-group, gender, blood type, clinical diagnosis, graft source, relationship between recipient and donor, and Child-Pugh classification, body weight, height, operation duration, and cold ischemia time.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Pham YH, Miloh T. Liver transplantation in children. Clin Liver Dis. 2018;22(4):807–21. 10.1016/j.cld.2018.06.004. - DOI - PubMed
    1. Kohli R, Cortes M, Heaton ND, Dhawan A. Liver transplantation in children: state of the art and future perspectives. Arch Dis Child. 2018;103(2):192–8. 10.1136/archdischild-2015-310023. - DOI - PubMed
    1. Cuenca AG, Kim HB, Vakili K. Pediatric liver transplantation. Semin Pediatr Surg. 2017;26(4):217–23. 10.1053/j.sempedsurg.2017.07.014. - DOI - PubMed
    1. Dommergues JP, Letierce A, Gravereau L, Plainguet F, Bernard O, Debray D. Current lifestyle of young adults after liver transplantation during childhood. Am J Transplant. 2010;10(7):1634–42. 10.1111/j.1600-6143.2010.03054.x. - DOI - PubMed
    1. Sharma S, Sharma P, Tyler LN. Transfusion of blood and blood products: indications and complications. Am Fam Physician. 2011;83(6):719–24. - PubMed