Pre transplant malnutrition predicts post transplant respiratory complications in living donor liver transplantation for biliary atresia- single center retrospective analysis of 110 children

Back Ground Biliary atresia is commonly associated with malnutrition and failure to thrive. Very few studies have been published on impact of preoperative malnutrition of post transplant outcome in these children. Material and Methods 110 children underwent living donor liver transplantation between January 2003 to march 2013.Pre transplant malnutrition was defined according to z scores for weight for age and height for age as per who definition. Patients having both Z score of < −2 were compared with control group. Statistical analysis were done using SPSS version 21 (IBM). Results 39 children out of 110 were having z score for weight for age < −2.There was no statistical difference between PELD score, graft weight, GRWR, intraoperative blood loss between to groups. 22 out of 39 patients in malnourished group developed clavein grade 3,garde 4 complications and 32 patients out of 71 in control group developed clavien grade 3 grade 4 complications. (p= 0.318). Over all mortality rate was 4.5% and mortality rates in malnourished vs control group was respectively 7.69% and 2.81% (p= 0.278). Total 14 patient developed postoperative pulmonary complications. Pulmonary complications were significantly high in malnourished group. p=0.003. Conclusion Preoperative malnutrition is associated with high postoperative pulmonary complication rate in liver transplantation for biliary atresia.