Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation

Table 3 Univariate analysis of preoperative, intraoperative and early postoperative data according to perioperative red blood cell volume transfused

Variables	mean ± SD or No. (%)		P value
	LTr, n = 103	HTr, n = 137
Male gender	48 (46.6)	58 (42.3)	0.565
Age (d)	764 ± 544	419 ± 350	< 0.001
Weight (kg)	10.67 ± 3.20	7.88 ± 2.29	< 0.001
Height (cm)	80.0 ± 12.1	69.4 ± 8.7	< 0.001
WAZ	-0.90 ± 1.20	-1.75 ± 1.21	< 0.001
HAZ	-0.11 ± 1.41	-0.54 ± 1.24	0.012
WHZ	-1.60 ± 1.34	-2.43 ± 1.48	< 0.001
BMIZ	0.20 ± 1.20	-0.36 ± 1.39	0.001
Ascites	72 (69.9)	115 (83.9)	0.036
PELD score	14.1 ± 6.2	19.1 ± 7.9	< 0.001
Extra-hepatic cholestasis	67 (65.0)	105 (76.6)	0.029
Intrahepatic cholestasis	13 (12,6)	5 (3.6)	0.002
Cirrhosis	6 (5.8)	12 (8.8)	0.373
Metabolic diseases	7 (6.8)	10 (7.3)	0.852
Malignant diseases	7 (6.8)	3 (2.2)	0.159
Miscellany	3 (2.9)	2 (1.5)	0.751
Kasai surgery	40 (38.8)	74 (54.0)	0.016
Portal hypertension	96 (93.2)	132 (96.3)	0.132
Hepatopulmonary syndrome	19 (18.4)	12 (8.7)	0.043
Infections ≤ 30 d pre-LT	0 ± 1	1 ± 1	0.01
eGFR (mL/min/1.73 m2)1	229 ± 121	188 ± 105	0.006
Hemoglobin (g/dL)2	10.2 ± 1.5	9.3 ± 1.5	< 0.001
Platelets (× 103/mm3)2	196 ± 112	193 ± 118	0.789
INR2	1.24 ± 0.25	1.49 ± 0.56	< 0.001
Sodium (mEq/L)2	137 ± 2.6	135 ± 4.4	< 0.001
Potassium (mEq/L)2	4.3 ± 0.5	4.4 ± 0.6	0.613
Glucose (mEq/L)2	104 ± 59	92 ± 60	0.313
Albumin (g/dL)2	2.9 ± 0.9	2.5 ± 0.8	0.002
Total bilirubin (g/dL)2	11.9 ± 7.3	13.4 ± 8.8	0.304
Hemoglobin (g/dL)3	8.6 ± 1.5	7.6 ± 1.2	< 0.001
INR3	1.23 ± 0.42	1.67 ± 0.75	< 0.001
Sodium (mEq/L)3	135 ± 8	134 ± 5	0.002
Warm ischemia time (min)	42.2 ± 12.9	42.9 ± 11.4	0.515
Cold ischemia time (min)	53.3 ± 34.8	67.1 ± 56.3	0.118
Anesthetic time (h)	9.7 ± 1.6	10.8 ± 1.9	< 0.001
Surgical time (h)	7.8 ± 1.5	9.0 ± 1.9	0.001
Crystalloid (mL/kg)4	179 ± 67	251 ± 105	0.015
Colloid (mL/kg)4	33.6 ± 20.8	43.1 ± 19.7	< 0.001
Diuresis (mL/kg)4	47.5 ± 22.9	61.3 ± 36.6	0.013
GBWR (%)	2.9 ± 1.0	3.9 ± 1.1	< 0.001
Extubation in OR	24 (23.1)	16 (11.8)	0.014
Intubation period ≥ 48 h	7 (6.7)	35 (25.7)	< 0.001
ICU length of stay (d)	4 ± 5	8 ± 13	0.001
Hospital length of stay (d)	17 ± 13	23 ± 21	0.010

¹Estimated glomerular filtration rate, preoperative calculated by Schwartz's formula.

²Blood samples collected up to 72 h before liver transplantation (LT) anesthetic induction.

³Blood samples collected up to 2 h after the onset of LT anesthetic induction.

⁴Intraoperative volume indexed by body's weight. Extra-hepatic cholestasis, extra-hepatic biliary atresia, coledocus cyst; intrahepatic cholestasis, Alagille's syndrome, non-syndromic biliary hypoplasia, primary sclerosing cholangitis, progressive intrahepatic familial cholestasis; cirrhosis, idiopathic, autoimune and cryptogenic; metabolic diseases, glycogenesis, Cligger-Najar's disease, tyrosinemia, cystic fibrosis, alpha-1 anti trypsin deficiency, urea cycle defects, type 1 oxaluria; malignant diseases, hepatoblastoma and hepatocarcinoma and hepatic miscellany diseases, Budd-Chiari syndrome, Caroli's disease and unclarified fibrosis. SD: Standard deviation; LTr: Low-volume transfusion group; HTr: High-volume transfusion group; WAZ: Weight-for-age z-score; HAZ: Height-for-age z-score; WHZ: Weight-for-height z-score; BMIZ: Body-mass-index-for-age z-score; PELD: Pediatric end-stage liver disease; LT: Liver transplantation; INR: International normalized ratio; GBWR: Graft-to-body-weight ratio; OR: Operating room; ICU: Intensive care unit; eGFR: Estimated glomerular filtration rate.