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. 2024 Aug 7;24(1):225.
doi: 10.1186/s12893-024-02520-1.

The effect of high-volume intraoperative fluid administration on outcomes among pediatric patients undergoing living donor liver transplantation

Zhen-Zhen Tu  1   2   3 , Lin Bai  1   2   4 , Xiao-Ke Dai  5   6 , Dong-Wei He  1   7 , Juan Song  1   8 , Ming-Man Zhang  9   10   11   12
Affiliations

The effect of high-volume intraoperative fluid administration on outcomes among pediatric patients undergoing living donor liver transplantation

Zhen-Zhen Tu et al. BMC Surg. .

Abstract

Background: Pediatric patients undergoing liver transplantation are particularly susceptible to complications arising from intraoperative fluid management strategies. Conventional liberal fluid administration has been challenged due to its association with increased perioperative morbidity. This study aimed to assess the impact of intraoperative high-volume fluid therapy on pediatric patients who are undergoing living donor liver transplantation (LDLT).

Methods: Conducted at the Children's Hospital of Chongqing Medical University from March 2018 to April 2021, this retrospective study involved 90 pediatric patients divided into high-volume and non-high-volume fluid administration groups based on the 80th percentile of fluid administered. We collected the perioperative parameters and postoperative information of two groups. Multivariable logistic regression was utilized to assess the association between estimated blood loss (EBL) and high-volume FA. Kaplan-Meier survival analysis was used to compare patient survival after pediatric LDLT.

Results: Patients in the high-volume FA group received a higher EBL and longer length of stay than that in the non-high-volume FA group. Multivariate logistic regression analysis indicated that hours of maintenance fluids and fresh frozen plasma were significantly associated risk factors for the occurrence of EBL during pediatric LDLT. In addition, survival analysis showed no significant differences in one-year mortality between the groups.

Conclusions: High-volume fluid administration during LDLT is linked with poorer intraoperative and postoperative outcomes among pediatric patients. These findings underscore the need for more conservative fluid management strategies in pediatric liver transplantations to enhance recovery and reduce complications.

Keywords: Fluid administration; Intraoperation; Living donor liver transplantation; Outcomes; Pediatric.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow chart. A total of 109 unique patients with BA were identified, 19 patients were excluded due to meeting the exclusion criteria. Finally, 90 patients were included in the study, and divided into two groups: High-volume FA group (n = 18) and non-High-volume FA (n = 72)
Fig. 2
Fig. 2
Kaplan-Meier curves of patient survival within 1 year of the pediatric liver transplantation
See this image and copyright information in PMC

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