Analysis of potential risk factors for early postoperative pulmonary infection after pediatric living donor liver transplantation

Abstract

To analyze the potential risk factors of early (≤ 30 days) postoperative pulmonary infection after pediatric living donor liver transplantation (LDLT) and explore the feasible preventive and therapeutic measures. Without preoperative respiratory disease, the clinical data of 36 cases undergoing LDLT at Children's Hospital of Chongqing Medical University between June 2006 and December 2009 were analyzed retrospectively so as to evaluate the incidence, prognosis and risk factors of early postoperative pulmonary infection. Univariate analysis was performed to determine the relative risk factors for postoperative pneumonia. And significant factors (P < 0.05) were then used for multivariate Logistic regression analysis. Twenty-four recipients suffered from early postoperative pulmonary infection at an incidence of 67% (24/36). The mortality rate in the pediatric patients who developed pulmonary infection was 17% (4/24). In univariate analysis, age ≤ 1 year, high Child-Pugh scores, hemoglobin < 90 g/L, congenital heart disease, mechanical ventilation > 12 hours, intraoperative transfusion > 150 ml/kg and indwelling gastric tube > 3 days were of statistical significance (all P < 0.05). Multivariate Logistic regression analysis showed age ≤ 1 year, intraoperative transfusion > 150 ml/kg and indwelling gastric tube > 3 days were independent risk factors for post-LDLT pneumonia (all P < 0.05). Pulmonary infection is an important factor of decreasing the survival rate during the early postoperative stage. To reduce the incidence of postoperative pulmonary infection and guarantee a successful transplantation, should improve the preoperative physical condition, restrict intraoperative fluid infusion with stable hemodynamics and strengthen gastric tube management.