Copyright
©The Author(s) 2023.
World J Gastrointest Surg. Sep 27, 2023; 15(9): 2021-2031
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.2021
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.2021
Table 1 Preoperative recipient-related data
Variable | Non-myocardial injury (n = 160) | Myocardial injury (n = 142) | P value |
Age (mo) | 9.5 (6.0-16.8) | 7.0 (6.0-11.0) | < 0.001 |
Male gender (%) | 78 (48.8) | 72 (50.7) | 0.735 |
Height (cm) | 70 (65-82) | 65 (62-70) | < 0.001 |
Weight (kg) | 8.0 (6.5-11.0) | 7.0 (6.0-8.0) | < 0.001 |
LVEF (%) | 64 (62-67) | 65 (62-67) | 0.167 |
QTc(ms) | 404 (387-427) | 405 (384-424) | 0.596 |
PELD score | 14 (4-21) | 22 (15-28) | < 0.001 |
ALT (U/L) | 106 (61-168) | 103 (70-172) | 0.494 |
AST (U/L) | 177 (103-319) | 196 (129-295) | 0.186 |
TB (µmol/L) | 166 (40-278) | 262 (157-349) | < 0.001 |
INR | 1.29 (1.09-1.63) | 1.52 (1.23-2.04) | < 0.001 |
Cr (µmol/L) | 14.0 (12.0-16.0) | 13.5 (10.0-16.0) | 0.528 |
Hemoglobin (g/L) | 93 ± 17 | 93 ± 16 | 0.671 |
Table 2 Intraoperative recipient-related data and donor-related data
Variable | Non-myocardial injury (n = 160) | Myocardial injury (n = 142) | P value |
Vital signs immediately before reperfusion | |||
HR (bpm/min) | 118 ± 13 | 117±13 | 0.515 |
MAP (mmHg) | 60 (54-67) | 56 (51-62) | 0.001 |
CVP (mmHg) | 5 (4-7) | 5 (3-7) | 0.454 |
Temperature (°C) | 36.5 (35.9-37.0) | 36.5 (35.8-37.0) | 0.652 |
Laboratory findings before reperfusion | |||
pH | 7.39 ± 0.07 | 7.39 ± 0.07 | 0.952 |
PCO2 (mmHg) | 34 (30-39) | 33 (30-38) | 0.148 |
PO2 (mmHg) | 257 (176-309) | 242 (170-312) | 0.472 |
Lactate (mmol/L) | 2.5 (1.8-3.2) | 2.7 (2.2-3.8) | 0.002 |
Base excess (mmol/L) | -4.2 (-6.5--1.7) | -4.8 (-6.8--3.1) | 0.102 |
Ca (mmol/L) | 1.08 (1.01-1.17) | 1.09 (1.00-1.15) | 0.648 |
K (mmol/L) | 3.8±0.6 | 3.8±0.5 | 0.448 |
Hemoglobin (g/L) | 84 (75-93) | 81 (72-91) | 0.038 |
Duration of anhepatic phase (min) | 56 (47-67) | 62 (50-76) | 0.019 |
Donor-related data | |||
Cold ischemic time (min) | 80 (64-106) | 90 (71-111) | 0.023 |
Graft weight (g) | 244 (217-277) | 243 (208-278) | 0.654 |
PRS (%) | 54 (33.8) | 76 (53.5) | 0.001 |
The data at the end of the surgery | |||
Duration of surgery (min) | 542 (495-600) | 540 (484-593) | 0.814 |
Duration of anesthesia (min) | 616 (555-651) | 610 (559-650) | 0.984 |
Blood loss (mL) | 300 (200-400) | 350 (200-400) | 0.378 |
Urine output (mL) | 400 (300-600) | 400 (248-600) | 0.909 |
RBCs transfusion (units) | 2.0 (1.5-3.0) | 2.0 (2.0-3.0) | 0.078 |
FFP transfusion (mL) | 0 (0-100) | 0 (0-200) | 0.009 |
Table 3 Postoperative recipient-related data
Variable | Non-myocardial injury (n = 160) | Myocardial injury (n =142) | P value |
Ventilation time (min) | 220 (129-351) | 196 (146-321) | 0.785 |
ICU stay (d) | 2 (2.0-3.0) | 3 (2.0-3.5) | 0.041 |
hospital stay (d) | 20 (16-29) | 21 (17-26) | 0.732 |
AKI (%) | 35 (21.9) | 35 (24.6) | 0.569 |
Liver function test during the first five days after LDLT | |||
Peak ALT (U/L) | 551 (386-972) | 619 (416-1151) | 0.108 |
Peak AST (U/L) | 666 (472-1186) | 748 (495-1386) | 0.103 |
Peak TB (µmol/L) | 80 (52-114) | 88 (65-126) | 0.034 |
One-year survival rate (%) | 157 (98.1) | 131 (92.3) | 0.015 |
Table 4 Univariate and multivariate analyses of risk factors for myocardial injury during pediatric living donor liver transplantation
Factor | Univariate analysis OR (95%CI) | P value | Multivariate analysis OR (95%CI) | P value |
Preoperative recipient-related data | ||||
Age | 0.989 (0.974-1.003) | 0.125 | ||
Male gender | 1.081 (0.688-1.699) | 0.735 | ||
Height | 0.969 (0.951-0.988) | 0.002 | 1.011 (0.964-1.060) | 0.659 |
Weight | 0.889 (0.827-0.955) | 0.001 | 0.953 (0.800-1.136) | 0.593 |
LVEF | 1.044 (0.980-1.112) | 0.178 | ||
QTc | 0.999 (0.990-1.008) | 0.774 | ||
PELD | 1.074 (1.049-1.100) | < 0.001 | 1.065 (1.013-1.121) | 0.014 |
ALT | 1.001 (0.999-1.002) | 0.540 | ||
AST | 1.001 (1.000-1.002) | 0.218 | ||
Total Bilirubin | 1.004 (1.002-1.006) | < 0.001 | 1.001 (0.999-1.003) | 0.353 |
INR | 2.167 (1.435-3.272) | < 0.001 | 0.957 (0.554-1.653) | 0.875 |
Creatinine | 0.99 (0.951-1.031) | 0.632 | ||
Hemoglobin | 1.031 (0.897-1.184) | 0.670 | ||
Vital signs immediately before reperfusion | ||||
HR | 0.994 (0.977-1.012) | 0.513 | ||
MAP | 0.971 (0.949-0.993) | 0.010 | 0.997 (0.971-1.023) | 0.819 |
CVP | 0.974 (0.896-1.057) | 0.524 | ||
Temperature | 1.088 (0.819-1.444) | 0.560 | ||
Laboratory findings before reperfusion | ||||
pH | 0.902 (0.032-25.155) | 0.952 | ||
PCO2 | 0.971 (0.935-1.009) | 0.129 | ||
PO2 | 0.999 (0.996-1.002) | 0.478 | ||
Lactate | 1.267 (1.092-1.469) | 0.002 | 1.158 (0.990-1.355) | 0.067 |
Base excess | 0.946 (0.881-1.015) | 0.122 | ||
Ca | 0.374 (0.066-2.117) | 0.266 | ||
K | 0.857 (0.575-1.277) | 0.447 | ||
Hemoglobin | 0.836 (0.713-0.981) | 0.029 | 0.956 (0.828-1.105) | 0.544 |
Duration of anhepatic phase | 1.019 (1.004-1.035) | 0.016 | 1.021 (1.003-1.040) | 0.025 |
Donor-related data | ||||
Cold ischemic time | 1.006 (1.001-1.012) | 0.016 | 1.003 (0.997-1.010) | 0.334 |
Graft weight | 0.999 (0.996-1.003) | 0.755 | ||
PRS | 2.260 (1.420-3.598) | 0.001 | 1.966 (1.111-3.480) | 0.020 |
The data at the end of the surgery | ||||
Duration of surgery | 1 (0.998-1.002) | 0.854 | ||
Duration of anesthesia | 1.001 (0.999-1.003) | 0.481 | ||
Blood loss | 1.001 (1.000-1.002) | 0.128 | ||
RBCs transfusion | 1.151 (0.970-1.366) | 0.107 | ||
FFP transfusion | 1.002 (1.000-1.004) | 0.017 | 1.001 (0.999-1.003) | 0.441 |
- Citation: Wu YL, Li TY, Gong XY, Che L, Sheng MW, Yu WL, Weng YQ. Risk factors for myocardial injury during living donor liver transplantation in pediatric patients with biliary atresia. World J Gastrointest Surg 2023; 15(9): 2021-2031
- URL: https://www.wjgnet.com/1948-9366/full/v15/i9/2021.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v15.i9.2021