Murat SÜTÇÜ, Mustafa Serdar CANTEZ, Nelgin GERENLİ, Özlem DURMAZ

Çocuk Karaciğer Nakil Alıcılarında Anemi Profili

Amaç: Karaciğer nakil alıcılarında nakil öncesi ve sonrası dosya kayıtlarından anemi sıklığı, etiyolojisi ve klinik önemi araştırıldı.Gereç ve Yöntem: Çalışmaya İstanbul Üniversitesi İstanbul Tıp Fakültesi Hepatobiliyer Cerrahi Bilim Dalı ve Pediatrik Hepatoloji Bilim Dalında Mayıs 2000 ve Şubat 2011 tarihleri arasında karaciğer nakli uygulanmış 97 çocuk hastadan dosyalarına ulaşılan 81 vaka alındı. Dosya kayıtlarından nakil öncesi ve nakil sonrası 1. gün, 1. hafta, 1. ay hematolojik bulgular kaydedildi.Bulgular: Çalışma grubunun çoğunluğu erkek cinsiyette %67.9 ve canlı vericiden %76.5 nakil olmuş vakalardan oluşmaktaydı. Nakil olma yaşı medyan 54 aydı ve nakil nedenlerinin çoğunluğunu hipersplenizm bulgularının eslik ettiği kolestatik karaciğer hastalıkları %37 , metabolik karaciğer hastalıkları %19.7 ve kriptojenik siroz %13.5 oluşturmaktaydı. Anemi nakil öncesi 50 %61.7 vakada saptanırken nakil sonrası 1. gün 63 %77.8 , 1. hafta 51 %63.0 ve 1. ay 41 %50.6 vakada görüldü. Vakalarda nakil öncesi anemi varlığı ile nakil sonrası anemi varlığı arasındaki ilişki anlamlı bulundu p

Anahtar Kelimeler:

Çocuk, karaciğer nakli, anemi

Profile of Anemia in Pediatric Liver Transplant Recipients

Objection: To investigate the frequency, etiology and clinical significance of anemia in pediatric liver transplant recipients according to the pre-transplant and post-transplant file records. Material and Method: The study included 81 of 97 children with complete file records who underwent liver transplantation between May 2000 and February 2011 at the Istanbul University Istanbul School of Medicine Departments of Hepatobiliary Surgery and Pediatric Hepatology. We recorded hemoglobin values before and at 1st day, 1st week and 1st month after transplantation. Results: Majority of the transplanted children were males 67.9% and transplant recipients from living donors 76.5% . The median age of the patients was 54 months and most common indications of transplantation were cholestatic liver diseases 37% , metabolic liver disease 19.7% and cryptogenic cirrhosis 13.5% mostly with signs of hypersplenism. Anemia was detected before transplantation n=50, 61.7% , first day n=63, 77.8% , first week n=51, 63.0% and first month n=41, 50.6% of transplantation. The mean Hb values before 10.0±1.4 g/dL , and first day 9.42±1.32 g/dL , first week 9.75±1.20 g/dL , and first month 10.2±1.56 g/dL of transplantation. The Hb change between pre- and post-transplant periods was significant. Splenomegaly was detected in 36 of 50 cases with anemia before transplantation. A significant difference was detected between splenomegaly and anemia before transplantation. Splenomegaly was detected in 19 of 41 cases with anemia in the first month of post-transplant. Conclusion: The frequency of anemia has increased during early period of transplantation 77.8% in first day while its incidence significantly decreased by 50.6% in the first month of transplantation due to ameliorating hypersplenism. In addition, splenomegaly that has determinant role in frequency of anemia during pre-transplant period had lost its significance after transplantation.

Keywords:

Child, liver transplant, anemia,

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