Comparison of physiological indicators during living-donor liver transplantation in infants and children / 中华器官移植杂志

ABSTRACT

Objective To explore the change characteristics of physiological indexes between infants and children during living-donor liver transplantation and discuss methods of regulation and control.Method In this study,42 patients were selected and assigned into two groups according to age:infants group (＜1 year,n =25),and children group (1-16 years,n =17).The preoperative and peri-operative characteristics,intra-operative operation conditions,internal environment changes before and after re-perfusion,postoperative mechanical ventilation time,ICU time,hospital time,infection rate,additional surgery,complications and survival were analyzed.Result PELD (MELD) score,historical surgery rate and hematokrit were lower in children group than in infants group (P＜ 0.05).Serum creatinine and lactate concentrations increased significantly in children group as compared with infants group (P＜0.05).Intra-operative an-hepatic phase and cold ischemia time were shortened significantly (P ＜ 0.05),and incidence rate of re-perfusion syndrome was reduced in children group as compared with infants group (P＜0.05).As compared with pre-re-perfusion,blood lactate concentrations were significantly raised only in infants group and glucose concentrations significantly raised only in children group (P＜0.05).The blood levels of K + were decreased after reperfusion in both two groups,and those in infants group were lower than in children group (P＜ 0.05).Postoperative intensive care unit time was longer in children group than in infants group (P＜ 0.05),and there was no significant difference in survival rate between two groups.Conclusion There are many differences and change characteristics to physiological indexes between infants and children during the operation of living-donor liver transplantation.Timely management and regulation are critical for the success of surgery according to the differences.