Abstract: Objective To retrospectively analyze the anesthesia process and prognosis of non‑transplant surgery for pediatric patients after liver transplantation, so as to provide evidence for perioperative anesthesia management in such patients. Methods A total of 25 pediatric patients who underwent non‑transplant surgery after liver transplantation in Shanghai Children's Medical Center from January 2017 to March 2020 were enrolled and their clinical data were collected. According to the type of surgery, the patients were divided into two groups: a transplant complication‑related surgery group (group R, n=15), and a non‑transplant complication‑related surgery group (group N, n=10). Their data concerning diagnosis process before surgery, laboratory examination, perioperative anesthesia and surgical records and post‑operative transfer were analyzed. Results All the patients received mechanical ventilation under general anesthesia. Patients in group R presented remarkable decreases in average age compared with those in group N (P<0.05), as well as increases in the proportion of emergency operations, American Society of Anesthesiologists (ASA) grades before surgery, operation and anesthesia time, and the incidence of cyclical fluctuation compared with those in group N (P<0.05). In group R, seven patients received blood products transfusion (including two cases of vasoactive agent use), six patients who were admitted to pediatric intensive care unit (PICU) after operation, where two children died within 24 h. Patients in group N returned to ward after operation, without perioperative death cases. Conclusions Pediatric patients who underwent transplant complication‑related surgery usually have complicated diseases, with poor general condition, long operation time, and obvious cyclical fluctuation during surgery. The postoperative PICU and postoperative 24 h mortality rate also significantly increase. Anesthesiologists need to perform more comprehensive evaluation and preparation before surgery, and more individualized anesthesia management during operation. In contrast, children undergoing non‑transplant complication‑related surgery usually have better preoperative conditions, with short operation time and better tolerance to surgery and anesthesia.
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