Transfusion-related acute hepatic injury following postoperative platelets administration in pediatric patients undergoing the Fontan procedure.
Acute Disease
Alanine Transaminase
/ blood
Aspartate Aminotransferases
/ blood
Biomarkers
/ blood
Female
Fontan Procedure
Heart Defects, Congenital
/ diagnostic imaging
Humans
Liver Diseases
/ blood
Male
Middle Aged
Platelet Transfusion
/ adverse effects
Retrospective Studies
Risk Factors
Treatment Outcome
Fontan
acute hepatic injury
congenital heart defect
pediatric cardiac surgery
platelets
transfusion-related acute hepatic injury
Journal
Congenital heart disease
ISSN: 1747-0803
Titre abrégé: Congenit Heart Dis
Pays: United States
ID NLM: 101256510
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
02
03
2019
revised:
11
05
2019
accepted:
08
07
2019
pubmed:
26
7
2019
medline:
1
7
2020
entrez:
26
7
2019
Statut:
ppublish
Résumé
The final common pathway of single ventricle patients is the Fontan procedure. Among the immediate postoperative complications is acute hepatic injury presented by marked elevation of liver enzymes (alanine transaminase [ALT] and aspartate transaminase [AST]). We aimed to determine the contribution of blood products transfusion to acute hepatic injury. Single center retrospective cohort study. Pediatric Cardiac Intensive Care Unit at a tertiary medical center. Ninety-nine pediatric patients undergoing the Fontan procedure between January 2009 and December 2016. None. Out of the four types of blood products, transfusion of platelets was found to significantly affect postoperative levels of ALT and AST. Additional factors included postoperative administration of sodium bicarbonate, decreased flow through the Fontan canal and decreased urine output. Preoperative pulmonary artery pressure and pulmonary vascular resistance, cardiopulmonary bypass time, aortic cross-clamp time, amount of postoperative bleeding, and vasoactive-inotropic score did not influence liver enzymes levels CONCLUSIONS: In pediatric Fontan patients, platelets transfusions contribute to an acute hepatic injury. The relation between platelets and transfusion-related acute lung injury (TRALI) has been well described, but this is the first time it is being described in regard to acute hepatic injury (TRAHI). Changing platelet transfusion strategy could decrease morbidity in Fontan patients but further research is needed.
Substances chimiques
Biomarkers
0
Aspartate Aminotransferases
EC 2.6.1.1
Alanine Transaminase
EC 2.6.1.2
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Pagination
968-977Informations de copyright
© 2019 Wiley Periodicals, Inc.
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