Abstract
The aim of this study was to analyze the influence of intraoperative blood loss, expressed as an index of the circulating blood volume (BL), on patient and graft survival and on morbidity after primary orthotopic liver transplantation (OLT) in a series of 40 consequetive children (Mann-Whitney test, Pearson test). The influence on patient survival could not be assessed due to the low mortality. Graft survival and overall morbidity were not affected. Increased BL led only to a higher incidence of postoperative bleeding, with a subsequent higher intervention rate. In the group of children aged 3.75 years or less, significantly higher BL was found compared to the older children. In addition, prolonged intensive care unit stays and ventilator times were observed in this younger age group. The BL thus has limited repercussions on graft survival and morbidity after primary pediatric OLT.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bijleveld CMA, Verwer R, Houwen RHJ, Slooff MJH (1989) Orthotope levertransplantatie bij kinderen. Ned Tijdschr Geneeskd 133: 1401–1406
Bontempo FA, Lewis JH, Van Thiel DH, et al (1985) The relation of preoperative coagulation findings to diagnosis, blood usage, and survival in adult liver transplantation. Transplantation 39: 532–536
Brems JJ, Hiatt JR, Colonna JO, et al (1987) Variables influencing the outcome following orthotopic liver transplantation. Arch Surg 122: 1109–1111
Busutill RW, Collona JO, Hiatt JR, Brems JJ, El Khoury G, Goldstein LI (1987) The first 100 liver transplants at UCLA. Ann Surg 206: 387–402
Busutill RW, Seu P, Millis JM, et al (1991) Liver transplantation in children. Ann Surg 213: 48–57
Esquivel CO, Iwatsuki S, Gordon RD, et al (1987) Indications for pediatric liver transplantation. J Pediatr 111: 1039–1045
Garcia de Silva EB, Gore SM, White DJG, Bourgeon A, Rolles K, and Calne RY. Analysis of risk factors in liver transplantation (1986) Transplant Proc 18: 1210–1212
Haagsma EB, Gips CH, Wesenhagen H, Van Imhoff GW, Krom RAF (1985) Liver disease and its effect on haemostasis during liver transplantation. Liver 5: 123–128
Heffron TG, Emond JC, Whitington PF, et al (1992) Biliary complications in pediatric liver transplantation. A comparison of reduced-size and whole grafts. Transplantation 53: 391–395
Iwatsuki S, Shaw BW Jr, Starzl TE. Liver transplantation for biliary atresia (1984) World J Surg 8: 51–56
Kalayoglu M, Stratta RJ, Sollinger HW, et al (1989) Liver transplantation in infants and children. J Pediatr Surg 24: 70–76
Kirby RM, McMaster P, Clements D, et al (1987) Orthotopic liver transplantation: postoperative complications and their management. Br J Surg 74: 3–11
Krom RAF, Wiesner RH, Rettke SR, et al (1989) The first 100 liver transplantant at the Mayo Clinic. Mayo Clinic Proc 64: 84–94
Langnas AN, Marujo W, Stratta RJ, Wood RP, Shaw BW Jr (1991) Vascular complications after orthotopic liver transplantation. Am J of Surg 161: 76–83
Lerut J, Tzakis AG, Bron K, et al (1987) Complications of venous reconstruction in human orthotopic liver transplantation. Ann Surg 205: 404–414
Motschman TL, Taswell HF, Brecher ME, et al (1989) Intraoperative blood loss and patient and graft survival in orthotopic liver transplantation: their relationship to clinical and laboratory data. Mayo Clin Proc 64: 346–355
National Institutes of Health Consensus Development Conference Statement (1984) Liver transplantation-June 20–23, 1983. Hepatology 4: 107S–110S
Otte JB, de Ville De Goyet J, Sokal E, et al (1988) Size reduction of the donor liver is a safe way to alleviate the shortage of size matched organs in pediatric liver transplantation. Ann Surg 211: 146–157
Ringe B, Pichlmayr R, and Burdelski M (1988) A new technique of hepatic vein reconstruction in partial liver transplantation. Transplant Int 1: 30–35
Rosman C, Klompmaker IJ, Bonsel GE, Bleichrodt RP, Arends JP, Slooff MJH (1990) The efficacy of selective bowel decontamination as infection prevention after liver transplantation. Transplant Proc 22: 1554–1555
Shaw BW Jr, Wood RP, Gordon RD, Iwatsuki S, Gillquist WP, Starzl TE (1985) Influence of selected patient variables and operative blood loss on six month survial following liver transplantation. Semin Liver Dis 5: 385–393
Starzl TE, Esquivel C, Gordon RD, Todo S (1987) Pediatric liver transplantation. Transplant Proc 19: 3230–3235
Starzl TE, Groth CT, Brettschneider L, et al (1968) Orthotopic homotransplantation of the human liver. Ann Surg 168: 392–415
Starzl TE, Hakala TR, Shaw BW Jr, et al (1984) A flexible procedure for multiple cadaveric organ procurement. Surg Gynecol Obstet 158: 223–230
Starzl TE, Iwatsuki S, Van Thiel DH, et al (1982) Evolution of liver transplantation. Hepatology 2: 614–636
Starzl TE, Miller C, Broznick B, Makowka L (1987) An improved technique for multiple organ harvesting. Surg Gynecol Obstet 165: 343–348
Stevens LH, Emond JC, Piper JB, et al (1992) Hepatic artery thrombosis in infants. Transplantation 53: 396–399
Stock PG, Estrin JA, Fryd DS, et al (1987) Prognostic perioperative factors in outcome following liver transplantation. Transplant Proc 19: 2427–2428
Stock PG, Estrin JA, Fryd DS, et al (1989) Factors influencing early survival after liver transplantation. Am J Surg 157: 215–219
Van der Bij W, Van Son WJ, Van der Berg APM, Tegzess AM, Torensma T, The TH (1989) Cytomegalovirus antigenemia: rapid diagnosis and relationship with CMV-associated clinical syndromes in renal allograft recipients. Transplant Proc 21: 2061–2064
Van der Putten ABMM, Bijleveld CMA, Slooff MJH, Wesenhagen H and Gips CH (1987) Selection criteria and decisions in 375 patients with liver disease considered for liver transplantation during 1977–1985. A prospective, descriptive study. Liver 7: 84–90
Van der Waay D (1985) Bacterial infection prophylaxis by selective bowel decontamination in liver transplant patients: general principles. In: Gips CH, Krom RAF (eds) Progress in liver transplantation. The Hague: Martinus Nijhoff: 93–98
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Peeters, P.M.J.G., ten Vergert, E.M., Bijleveld, C.M.A. et al. The influence of intraoperative blood loss on graft survival and morbidity after orthotopic liver transplantation in children. Pediatr Surg Int 10, 120–125 (1995). https://doi.org/10.1007/BF00171171
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00171171