Reoperative complications following pediatric liver transplantation

Dor Yoeli, Ruth L. Ackah, Rohini R. Sigireddi, Michael Kueht, N. Thao N. Galvan, Ronald T. Cotton, Abbas Rana, Christine A. O'Mahony, John A. Goss

Research output: Contribution to journalArticle

Abstract

Background: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. Methods: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation. Results: Among the 144 pediatric liver transplants performed during the study period, 9% of the recipients required reoperation. The most common indications for reoperation were bleeding and bowel complications. There was no significant difference in the graft survival of patients with a reoperation and those without a reoperation (p = 0.780), but patients with a reoperation had a significantly longer hospital length of stay (median of 39 days vs. 11 days, p = 0.001). Variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate were significantly associated with reoperation upon univariable logistic regression, but none of these risk factors remained statistically significant upon multivariable regression. Conclusion: At our institution, reoperation did not significantly impact graft survival. We identified variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate as risk factors for reoperation, although none of these risk factors demonstrated independent association with reoperation in a multivariable model. Type of study: Prognosis Study. Level of evidence: Level III.

Original languageEnglish (US)
Pages (from-to)2240-2244
Number of pages5
JournalJournal of Pediatric Surgery
Volume53
Issue number11
DOIs
StatePublished - Nov 1 2018
Externally publishedYes

Fingerprint

Reoperation
Liver Transplantation
Pediatrics
Transplants
Graft Survival
Operative Time
Blood Transfusion
Length of Stay
Anatomy
Blood Platelets
Erythrocytes
Tissue Donors
Weights and Measures
Liver
Operating Rooms
Logistic Models
Hemorrhage
Incidence

Keywords

  • hemorrhage
  • intestinal perforation
  • length of stay
  • postoperative complications
  • survival

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Yoeli, D., Ackah, R. L., Sigireddi, R. R., Kueht, M., Galvan, N. T. N., Cotton, R. T., ... Goss, J. A. (2018). Reoperative complications following pediatric liver transplantation. Journal of Pediatric Surgery, 53(11), 2240-2244. https://doi.org/10.1016/j.jpedsurg.2018.04.001

Reoperative complications following pediatric liver transplantation. / Yoeli, Dor; Ackah, Ruth L.; Sigireddi, Rohini R.; Kueht, Michael; Galvan, N. Thao N.; Cotton, Ronald T.; Rana, Abbas; O'Mahony, Christine A.; Goss, John A.

In: Journal of Pediatric Surgery, Vol. 53, No. 11, 01.11.2018, p. 2240-2244.

Research output: Contribution to journalArticle

Yoeli, D, Ackah, RL, Sigireddi, RR, Kueht, M, Galvan, NTN, Cotton, RT, Rana, A, O'Mahony, CA & Goss, JA 2018, 'Reoperative complications following pediatric liver transplantation', Journal of Pediatric Surgery, vol. 53, no. 11, pp. 2240-2244. https://doi.org/10.1016/j.jpedsurg.2018.04.001
Yoeli, Dor ; Ackah, Ruth L. ; Sigireddi, Rohini R. ; Kueht, Michael ; Galvan, N. Thao N. ; Cotton, Ronald T. ; Rana, Abbas ; O'Mahony, Christine A. ; Goss, John A. / Reoperative complications following pediatric liver transplantation. In: Journal of Pediatric Surgery. 2018 ; Vol. 53, No. 11. pp. 2240-2244.
@article{2ef1feb2de774a2f991fc14800bdf695,
title = "Reoperative complications following pediatric liver transplantation",
abstract = "Background: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. Methods: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation. Results: Among the 144 pediatric liver transplants performed during the study period, 9{\%} of the recipients required reoperation. The most common indications for reoperation were bleeding and bowel complications. There was no significant difference in the graft survival of patients with a reoperation and those without a reoperation (p = 0.780), but patients with a reoperation had a significantly longer hospital length of stay (median of 39 days vs. 11 days, p = 0.001). Variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate were significantly associated with reoperation upon univariable logistic regression, but none of these risk factors remained statistically significant upon multivariable regression. Conclusion: At our institution, reoperation did not significantly impact graft survival. We identified variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate as risk factors for reoperation, although none of these risk factors demonstrated independent association with reoperation in a multivariable model. Type of study: Prognosis Study. Level of evidence: Level III.",
keywords = "hemorrhage, intestinal perforation, length of stay, postoperative complications, survival",
author = "Dor Yoeli and Ackah, {Ruth L.} and Sigireddi, {Rohini R.} and Michael Kueht and Galvan, {N. Thao N.} and Cotton, {Ronald T.} and Abbas Rana and O'Mahony, {Christine A.} and Goss, {John A.}",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.jpedsurg.2018.04.001",
language = "English (US)",
volume = "53",
pages = "2240--2244",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "11",

}

TY - JOUR

T1 - Reoperative complications following pediatric liver transplantation

AU - Yoeli, Dor

AU - Ackah, Ruth L.

AU - Sigireddi, Rohini R.

AU - Kueht, Michael

AU - Galvan, N. Thao N.

AU - Cotton, Ronald T.

AU - Rana, Abbas

AU - O'Mahony, Christine A.

AU - Goss, John A.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. Methods: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation. Results: Among the 144 pediatric liver transplants performed during the study period, 9% of the recipients required reoperation. The most common indications for reoperation were bleeding and bowel complications. There was no significant difference in the graft survival of patients with a reoperation and those without a reoperation (p = 0.780), but patients with a reoperation had a significantly longer hospital length of stay (median of 39 days vs. 11 days, p = 0.001). Variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate were significantly associated with reoperation upon univariable logistic regression, but none of these risk factors remained statistically significant upon multivariable regression. Conclusion: At our institution, reoperation did not significantly impact graft survival. We identified variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate as risk factors for reoperation, although none of these risk factors demonstrated independent association with reoperation in a multivariable model. Type of study: Prognosis Study. Level of evidence: Level III.

AB - Background: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. Methods: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation. Results: Among the 144 pediatric liver transplants performed during the study period, 9% of the recipients required reoperation. The most common indications for reoperation were bleeding and bowel complications. There was no significant difference in the graft survival of patients with a reoperation and those without a reoperation (p = 0.780), but patients with a reoperation had a significantly longer hospital length of stay (median of 39 days vs. 11 days, p = 0.001). Variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate were significantly associated with reoperation upon univariable logistic regression, but none of these risk factors remained statistically significant upon multivariable regression. Conclusion: At our institution, reoperation did not significantly impact graft survival. We identified variant donor arterial anatomy, transplant operative time, intraoperative blood loss, transfusion volume of packed red blood cells or cell saver per weight, and transfusion with fresh frozen plasma, platelets, or cryoprecipitate as risk factors for reoperation, although none of these risk factors demonstrated independent association with reoperation in a multivariable model. Type of study: Prognosis Study. Level of evidence: Level III.

KW - hemorrhage

KW - intestinal perforation

KW - length of stay

KW - postoperative complications

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=85046170620&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046170620&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2018.04.001

DO - 10.1016/j.jpedsurg.2018.04.001

M3 - Article

C2 - 29706445

AN - SCOPUS:85046170620

VL - 53

SP - 2240

EP - 2244

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 11

ER -