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| 1 | Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation显示文摘BACKGROUND The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLDLT)must still be ascertained,mainly among young children.Clinical and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver transplantation.AIM To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing PLDLT.METHODS We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLDLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative complications.The receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/kg.Subsequently,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be analyzed.RESULTS High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up period.During a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the LTr.Over a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection complications.Additionally,Cox hazard regression found that high-volume RBC transfusion increased the mortality risk by 3.031-fold compared to low-volume transfusion.The Kaplan-Meier survival curves of the studied groups were compared using log-rank tests and the analysis showed significantly decreased graft survival,but with no impact in patient survival related to major complications.On the other hand,there was a significant decrease in both graft and patient survival,with high-volume RBC transfusion.CONCLUSION Transfusion of RBC volume higher than 27.5 mL/kg during the perioperative period is associated with a significant increase in short-and long-term postoperative morbidity and mortality after PLDLT. | Karina Gordon Estela Regina Ramos Figueira Joel Avancini Rocha-Filho Luiz Antonio Mondadori Eduardo Henrique Giroud Joaquim Joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla Jose Otavio Costa Auler Jr Maria Jose Carvalho Carmona Luiz Augusto Carneiro D'Alburquerque | 2021 | World Journal of Gastroenterology2021，27，12： | 6 |
| 2 | Immunohistochemical localization of macrophages and microglia in the adult and developing mouse brain显示文摘 | Perry VH Hume DA Gordon S | 1985 | Neurosci1985，15，2： | 1 |
| 3 | Ecological and evolutionary forces shaping microbial diversity in the human intestine显示文摘 | Ley RE Peterson DA Gordon JI | | 0，，04： | 1 |
| 4 | Ecological and evolu- tionary forces shaping microbial diversity in the human in- testine 显示文摘 | Ley RE Peterson DA Gordon JI | 2006 | Cell2006，124，： | 1 |
| 5 | Case report:a 32-year-old woman with familial paragangliomas and acute cardiomyopathy显示文摘 | Gordon RY Fallon JT Baran DA | 2004 | Transplant Proc2004，36，9： | 1 |
| 6 | Ecological and evolutionary forces shaping microbial diversity in the human intestine显示文摘 | Ley RE Peterson DA Gordon JI | 2006 | Cell2006，124，4： | 1 |
| 7 | Phagocytosis stimulates alternative glycosylation of macrosialin ( mouse CD68 ), a macrophage-specific endosomal protein显示文摘 | Da Silva RP Gordon S | 1999 | Biochem J1999，338，3： | 1 |
| 8 | Evaluation,treatment,and prevention of vitamin D deficiency:an Endocrine Society clinical practice guideline显示文摘 | Holick MF Binkley NC Bischoff-Ferrari HA Gordon CM Hanley DA Heaney RP Murad MH Weaver CM | | 0，，： | 1 |
| 9 | Ecological and evolutionary forces shaping microbial diversity in the human intestine显示文摘 | Ley RE Peterson DA Gordon JI | | 0，，： | 1 |
| 10 | Ecological and evolutionary forces shaping microbial diversity in the human intestine显示文摘 | Ley RE Peterson DA Gordon JI | | 0，，04： | 1 |
| 11 | Dynamic digital traction for unstable comminutcd intra articalar fracture dislocation of the proximal into erphalangeal joint 显示文摘 | Morgan JP Gordon DA Klug MS ct al | 1995 | J Hand Surg1995，20，4： | 1 |
| 12 | Relationship between social factors and pituitary - adrenocortical activity in female rhesus monkeys (Macaca mulatta)显示文摘 | Gust DA Gordon TP Hambright MK Wilson ME 1993 | 1993 | Horm Behav1993，27，3： | 1 |
| 13 | The human gut mierobiota and undemuttition显示文摘 | Gordon JI Dewey KG Mills DA | 2012 | Sei Transl Med2012，4，13： | 1 |
| 14 | Physical activity and osteoporosis: disparities between knowledge and practice显示文摘 | Gordon PM Newcomer RR Krummel DA | 2001 | W V Med J2001，97，3： | 1 |
| 15 | Ecological and evolutionary forces shaping microbial diversity in the human intestine显示文摘 | Ley RE Peterson DA Gordon JI | | 0，，04： | 1 |
| 16 | Effect of yoga exercise therapy on oxidative stress indicators with end-stage renal disease on hemodialysis显示文摘 | Gordon L McGrowder DA Pena YT | 2013 | Int J Yoga2013，6，1： | 1 |
| 17 | Origin and Phylogeny of Microbes Living in Permanent Antarctic Lake Ice显示文摘 | Gordon DA Priscu J Giovannoni S | 2000 | Microb Ecol2000，39，3： | 1 |
| 18 | Ecological and evolutio- nary forces shaping microbial diversity in the human intestine 显示文摘 | Ley RE Peterson DA Gordon JI | 2006 | Cell2006，124，4： | 1 |
| 19 | Ecological and evolutionary forces shaping microbial diversity in the human intestine 显示文摘 | Ley RE Petemon DA Gordon JI | 2006 | Cell2006，124，41： | 1 |
| 20 | Ecological and evolutionary forces shaping microbial diversity in the human intestine显示文摘 | Ley RE Peterson DA Gordon JI | 2006 | Ce112006，124，4： | 1 |
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