Background: The aim of this study is to identify risk factors for massive intraoperative blood loss in pediatric liver transplant recipients and describe its impact on graft survival and hospital length of stay (LOS).

Methods: All first pediatric liver transplants performed at our institution between September 2007 and September 2016 were reviewed. Data is presented as n (%) or median (interquartile range). Estimated blood loss (EBL) was standardized by weight. Massive blood loss was defined as >90th percentile. Logistic regression, Mann-Whitney U, Pearson chi-square, and log-rank tests were used.

Results: 250 transplants were performed during the study period. Median EBL was 9.8 (5.5-21.5) cc/kg and 90th percentile was 51.7 cc/kg. 25 (10%) recipients had massive EBL. The recipient, donor, and operative characteristics are summarized in Table 1. Recipients with massive EBL did not have worse graft survival (p = 0.582). Median post-transplant LOS among recipients with massive EBL was 36 (19-59) days compared to 12 (7-22) days among those without massive EBL (p < 0.001). Upon multivariate logistic regression, being home at time of allocation (OR 0.07, 95% CI 0.01-0.34) and operative time (OR 2.51, 95% CI 1.63-3.88) were significantly associated with massive EBL.

Conclusion: Pediatric liver transplant recipients with massive EBL did not have worse graft survival, but did have significantly longer post-transplant LOS. Longer operative time was a significant risk factor for massive EBL, while being admitted from home for transplantation was a protective factor.

CITATION INFORMATION: Kohler J., Yoeli D., Sigireddi R., Ackah R., Kueht M., Galvan T., Cotton R., Rana A., O'Mahony C., Goss J. Intraoperative Blood Loss during Pediatric Liver Transplantation: A Single Center Experience Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress