ABSTRACT 861

Abstract

Background and aims: Following liver transplantation (LT), patients admitted in intensive care unit have multiple organ dysfunction syndrome (MODS). Most death occurs within the first three months. The Pediatric Logistic Organ Dysfunction (PELOD) score has been developed to describe and quantify the severity of the MODS in children. Aims: To characterize MODS in the post operative course of pediatric liver transplantation and identify risk factors of mortality. Methods: We included 183 patients admitted to our unit between January 1st, 2006 and the December 31th, 2010 following LT. We compared the pre-, intra- and post-operative characteristics between the survivors and nonsurvivors. The relationship between the daily PELOD score, the daily number of organ dysfunctions, the daily organ dysfunction and mortality were studied by using an univariate and a logistic regression analysis. Results: In the multivariate analysis, risk factors of mortality were the PELOD score on admission (odds ratio (OR) 1.13, 95% confidence interval (CI) [1.03, 1.25], p = 0.01), transfusion of >2 blood volumes (OR 1.65, 95% CI [1.63, 2.55], p = 0.03) and primary dysfunction (OR 47.62, 95% CI [5.55, 500], p <0.0001). MODS on day three increased the risk of death. Renal and respiratory dysfunction were independent predictors of death (OR 11, 95% CI [2.8, 43.5], p = 0.0006 and OR 10.2, 95% CI [1.2, 86.8], p = 0.03, respectively). Conclusions: Renal and respiratory failures strongly impact outcome following LT in children. These risk factors may help to discriminate patients at high risk of postoperative mortality.