Pulmonary complications after liver transplantation in children

Introduction: Liver transplantation (LT) is associated with an increased risk of post-transplant morbidity despite high survive. While pulmonary complications in adult patients with LT have been evaluated, there are very few studies in paediatric patients. We aimed to evaluate pulmonary complications in paediatric patients with LT in our centre. Methods: The results of 41 patients who underwent LT in our centre between January 2014 and January 2022 were evaluated retrospectively. Patients9 age, gender, causes of LT, need for post-transplant invasive mechanical ventilation (IMV) and non-invasive MV (NIV), length of stay in the intensive care unit (ICU) and hospital, presence of pulmonary complications, current respiratory support was examined. Atelectasis, pleural effusion, pneumonia, pulmonary edema and diaphragm paralysis were accepted among pulmonary complications. Results: Twenty-seven (65.9%) of the patients were male. The median age at LT was 31 (5-201) months. The most common causes of LT were idiopathic liver failure (n=12), biliary atresia (n=9), and metabolic disease (n=7). The median duration of post-transplantation IMV and NIV need was 2 (1-18) and 2 (0-57) days, respectively. Pulmonary complications developed in 31 (75.6%) patients (Table 1). The median duration of ICU and hospital stay of the patients was 7 (3-60) and 48 (5-280) days, respectively. Thirty-four (82.9%) patients are still in follow-up, and the median follow-up period was 17 (0-87) months. Currently, no patient needs respiratory support. Conclusions: Although the risk of developing pulmonary complications after paediatric LT is high, the complications do not cause morbidity that requires long term respiratory support.