Risk factors for morbidity in Pediatric liver transplantation at AIMS, Kochi. International Journal of Nursing Education
Publication Type:Journal Article
Source:Volume 8, Number 3, p.149-154 (2016)
Keywords:LT-Liver Transplantation, MELD-Model for End stage Liver Disease, PELD-Pediatric End stage Liver Disease, PLT-Pediatric Liver Transplantation.eMR-electronic Medical Record
Liver Transplantation (LT) revolutionized the management of liver disease. LT has been very successful in treating children with end stage liver disease, and offers the opportunity for long healthy life. Rejection and infection are important adverse events after Pediatric Liver Transplantation (PLT). The objectives of the study are to identify the risk factors for morbidity in the LT children.
Method & Tools
A descriptive single centered study explored during 2006–2015, total number of children underwent LT was 50. The electronic Medical Records (eMR) were used with the permission of administrative authority and ethical approval from thesis review committee at AIMS. The data which includes socio demographic, specific donor characteristics, clinical profile of liver transplantation recipients, assumed risk factors were scrutinized in preoperative and post-transplant recipients.
Out of 50 LT children, 36(72%) are survivors and 14(28%) were died in which 19(38%) were males and 31(62%) were females of ages ranging from 6 months to 17 years. The primary diagnosis noticed for the LT was Biliary atresia, Fulminant hepatic failure, Wilson's disease, Cirrhosis of liver respectively. The pre and post-transplant nutritional status of the children were very poor. Of all transplants 48(96%) were Living-related liver transplantation and 2(4%) were whole liver transplantation in which 29(58%) grafts were left lobe. For 39(78%) children donors were mothers. Bacterial infections were most frequent 41(82%) followed by viral 16(32%) and fungal 3 (6%). Among 50, 18(36%) of LT children has pleural effusion, typically on the right side, 12(24%) had bile leakage and 8(16%) had acute rejection.
Liver failure due to rejection was the major cause of death after LT. The risks for mortality and morbidity after LT is a multifactorial problem and all factors to be listed and need attention to give each to reduce this risk of better outcome.
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