Postoperative hypoalbuminemia and outcomes of pediatric liver transplantation
Issued Date
2024-12-01
Resource Type
eISSN
14712431
Scopus ID
2-s2.0-85195655650
Journal Title
BMC Pediatrics
Volume
24
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Pediatrics Vol.24 No.1 (2024)
Suggested Citation
Uasuwannakul A., Lertudomphonwanit C., Anantasit N., Tanpowpong P., Getsuwan S., Thirapattaraphan C., Treepongkaruna S. Postoperative hypoalbuminemia and outcomes of pediatric liver transplantation. BMC Pediatrics Vol.24 No.1 (2024). doi:10.1186/s12887-024-04831-x Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/98826
Title
Postoperative hypoalbuminemia and outcomes of pediatric liver transplantation
Author's Affiliation
Corresponding Author(s)
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Abstract
Background: Hypoalbuminemia after liver transplantation (LT) is associated with acute kidney injury (AKI) and poor outcomes in adult LT recipients. This study was performed to examine the association between the postoperative serum albumin level and early postoperative outcomes of LT in children. Methods: This single-center retrospective review involved pediatric LT recipients (0–18 years old) treated from January 2013 to June 2020. All patients were admitted to PICU and received standard post-LT care protocol. We divided patients into low (< 30 g/L) and normal (> 30 g/L) groups based on postoperative albumin day 1 to 3. Results: Among 108 LT recipients, most had biliary atresia. The median age at the time of LT was 1.8 years [interquartile range (IQR), 1.5–5.7]. There were 18 patients in low albumin group [median albumin level, 27.9 g/L (IQR, 25.8–29.6) and 90 patients in normal albumin group [median albumin level, 34.5 g/L (IQR, 32.4–36.9). The low albumin group had significantly higher incidence of AKI, occurring in 20% of patients with a median onset of 2.5 days following LT (IQR, 1–5). Postoperative hypoalbuminemia (OR, 4.94; 95% CI, 1.32–18.47; p = 0.01) and a longer operative time (OR, 1.37; 95% CI, 1.01–1.47; p = 0.02) were independent risk factors for AKI by multivariable analysis. No significant differences between the two groups were found in other early postoperative outcomes. Conclusion: Postoperative hypoalbuminemia was associated with early postoperative AKI following LT in children but not with other worsening outcomes.