Risk Factors of Hypothermia During Pediatric Liver Transplantation Using a Novel Warming Method

Background: Intraoperative hypothermia often occurs in patients under general anesthesia, including liver transplantation (LT), leading to various life-threatening conditions. This study aimed to evaluate factors causing hypothermia in patients undergoing pediatric LT.

Methods: Data were collected from patients undergoing LT who were warmed during surgery. The participants were divided into the hypothermia group, comprising patients with intraoperative hypothermia (< 35°C), and the normothermia group, comprising patients without hypothermia (≧ 35°C). These two groups were compared in terms of preoperative conditions (weight, height, Body mass index, age [months], and pediatric end-stage liver disease score), intraoperative findings (surgical duration, graft-to-recipient weight ratio, cold ischemic time, warm ischemic time, length of the an-hepatic period, volume of blood loss, and volume of blood transfusion), and postoperative findings (complications within 30 days, rejection within 30 days, and length of intensive care unit and hospital admission).

Results: The hypothermia and normothermia groups differed in terms of age, weight, height, pediatric end-stage liver disease score, graft-to-recipient weight ratio, volume of blood loss, volume of blood transfusion (red cell concentrate and fresh frozen plasma), the duration of intensive care unit admission, and rejection within 30 days (all p < 0.05). After multivariate analysis, only the number of patients experiencing rejection was associated with intraoperative hypothermia (odds ratio = 32.553, 95%CI: 2.198-482.226, p = 0.011).

Conclusions: Rejection was particularly related to intraoperative hypothermia.