Fluid Overload and Graft Injury Following Pediatric Liver Transplantation: A Single-Center Analysis

Area of Science:

• Pediatric Hepatology
• Transplantation Medicine
• Critical Care Medicine

Background:

• Liver transplantation is a complex procedure with potential complications.
• Fluid balance management is crucial in the postoperative period for pediatric liver transplant recipients.
• Understanding the impact of fluid balance on graft injury and complications is essential.

Purpose of the Study:

• To compare graft injury and complications in pediatric liver transplant recipients based on fluid balance.
• To investigate the association between fluid balance and graft injury markers (ALT, bilirubin).
• To examine the relationship between fluid balance and vascular complications and long-term graft function.

Main Methods:

• Retrospective cohort study of 79 pediatric liver transplant recipients.
• Analysis of fluid balance in the first six postoperative days.
• Assessment of associations between fluid balance, graft injury markers (delta ALT, delta bilirubin), vascular complications, and mean ALT at one year.

Main Results:

• Higher cumulative fluid balance in the first three postoperative days was associated with vascular complications.
• Fluid overload on postoperative days 0 and 2 correlated with increased risk of vascular complications.
• Negative correlation between fluid balance and delta ALT on postoperative day 2.
• Excessive fluid balance (>200 mL/kg) in the first three days linked to higher mean ALT levels at one year.

Conclusions:

• Fluid overload is associated with vascular complications and graft injury markers in pediatric liver transplantation.
• Findings suggest a potential role for optimized fluid management in improving outcomes.
• Further prospective studies are required to confirm these associations and guide clinical practice.