儿童肝移植围手术期输血

Perioperative blood transfusion in pediatric liver transplantation

背景输血是儿童肝移植围手术期重要的治疗手段之一，输血对患儿预后的影响越来越被重视。目的综述输血对患儿预后的影响和输血进展，为临床工作提供参考。内容介绍输血对肝移植患儿预后可能造成的不良影响：术中输注红细胞是术后病死率的主要预测因素，其他因素包括感染增加、动脉栓塞的发生率等。血液管理目标为：减少出血、避免不必要的输血、降低输血阈值，从而提高患儿术后生存率、减少术后并发症。趋向儿童肝移植围手术期血液管理趋势是：合理用血，减少术后并发症，提高术后患儿生存率。

Background Blood management is an important treatment measure in pediatric liver transplantation, however multiple studies have demonstrated blood transfusions have negative effects on the prognosis of patients.Objective The progress of blood transfusion of pediatric liver transplantation is summarized to provide reference to clinical practice.Content Blood management is an important treatment measure in pediatric liver transplantation. However, multiple studies have shown the intraoperative transfusion of RBC was a major predictor of post-operative mortality in patients undergone liver transplantation. Other factors include increased rates of infection and hepatic artery thrombosis associated with RBC transfusions. The aim of blood management is to protect the patient from unnecessary or excessive transfusions, minimizing RBC transfusion and improving patient outcomes.Trend The trend of blood management is to protect the patient of pediatric liver transplantation from unnecessary or excessive transfusions with the ultimate goal of improving patient outcomes.