Factors associated with postoperative respiratory conditions and critical outcomes on pediatric liver transplantation: A single-center experience

Jeng Hung Wu, Chin Su Liu, Hsin Lin Tsai, Chih Ting Su, Yi Hsuan Tang, Yu Sheng Lee, Pei Chen Tsao, Yi Ting Yeh, Wei Yu Chen, Mei Jy Jeng*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Orthotopic liver transplantation (OLT) is an established therapeutic option for pediatric end-stage liver disease (PELD). The postoperative respiratory conditions of OLT recipients may be associated with subsequent clinical outcomes including length of stay (LOS) in the pediatric intensive care unit (PICU). This study aimed to characterize the postoperative respiratory conditions, associated factors, and outcomes after pediatric OLT. Methods: Clinical data of children receiving OLT from July 2014 to July 2020 were retrospectively collected. Postoperative respiratory conditions were defined as time to extubation, significant pleural effusion, and initial postoperative PaO2/FiO2ratio. Logistic and multiple regressions were applied to analyze the associations among clinical factors, postoperative respiratory conditions, and clinical outcomes. Results: Twenty-two patients with median age of 1.4-year-old (range: 25 days to 12 years old) were analyzed. Mortality within 28 days was 4.5% and median LOS in the PICU was 18 days. Of 22 patients, 11 patients (50.0%) were extubated over 24 hours after surgery, and 8 patients (36.4%) required drainage for pleural effusions. Longer LOS in the PICU were noted in patients extubated over 24 hours (p = 0.008), complicated with significant pleural effusions (p = 0.02) after surgery, and having low initial postoperative PaO2/FiO2(<300 mmHg) (p = 0.001). Among clinical factors, massive intraoperative blood transfusion (>40 mL/kg) was significantly associated with prolonged intubations, significant pleural effusions, low initial postoperative PaO2/FiO2, and prolonged LOS in the PICU (>14 days). The initial postoperative PaO2/FiO2significantly depended on age, disease severity (PELD score), and whether the patient received massive intraoperative blood transfusion. Conclusion: Pediatric patients of OLT with poor postoperative respiratory conditions including low initial PaO2/FiO2ratio, extubation over 24 hours or significant pleural effusions have longer LOS in the PICU, and the requirement of massive intraoperative transfusion was a risk factor for both poor postoperative respiratory conditions and prolonged LOS in the PICU.

Original languageEnglish
Pages (from-to)369-374
Number of pages6
JournalJournal of the Chinese Medical Association
Issue number3
StatePublished - 1 Mar 2022


  • Massive blood transfusion
  • Orthotopic liver transplantation
  • Pediatric intensive care unit
  • Postoperative respiratory conditions
  • Prognosis


Dive into the research topics of 'Factors associated with postoperative respiratory conditions and critical outcomes on pediatric liver transplantation: A single-center experience'. Together they form a unique fingerprint.

Cite this