Pleural Effusion After Pediatric Liver Transplantation Linked to Increased Morbidity: Study

A new study published in the Pakistan Journal of Medical Sciences showed that in children receiving liver transplants, pleural effusion is a frequent postoperative complication that is linked to higher morbidity, especially in individuals who need therapeutic drainage.

For kids with acute liver failure and end-stage liver disease, pediatric liver transplantation (LT) is a life-saving, curative treatment. Despite considerable surgical and critical care breakthroughs boosting long-term survival rates, pulmonary problems remain a prominent cause of postoperative morbidity. Approximately 60% of pediatric LT patients have pleural effusion, which is one of the most common problems. Usually occurring in the first week following surgery, this fluid buildup has the potential to worsen respiratory function, prolong mechanical ventilation, and lengthen hospitalizations in critical care.

A high Pediatric End-Stage Liver Disease (PELD) score (≥18), severe malnutrition, low preoperative fibrinogen, hypoalbuminemia, and positive intraoperative fluid balances are important risk factors that put these susceptible kids at risk for pleural effusion. To maximize respiratory outcomes and speed up overall pediatric patient recovery rates, early detection and focused therapy of these particular risk factors are extremely essential. This study evaluated the prevalence, risk factors, and clinical importance of pediatric post-LT pleural effusion.

60 children who received liver transplants at the facility between July 2021 and April 2024 were included in this retrospective cohort research from a single facility. To identify variables associated with the development of pleural effusion, preoperative, perioperative, intraoperative, and postoperative data were gathered and assessed. SPSS version 26.0 was used to enter and analyze the data.

36 out of 60 pediatric patients (60%) had pleural effusion following liver transplantation (LT). Patients with pleural effusions were shown to have several significant risk factors. These included decreased pretreatment levels of fibrinogen, albumin, and hemoglobin; malnourishment; and a Pediatric End-Stage Liver Disease (PELD) score of ≥18.

The risk variables for postoperative pleural effusion in patients with postoperative fibrinogen, albumin, protein, INR, APTT, platelets, and hemoglobin levels were assessed using a binary logistic model. The odds ratio for having multiple effusions was 34.545 for serum albumin level (B).

Overall, pleural effusion is a common postoperative complication in children receiving liver transplantation, and it is associated with increased morbidity, particularly in those patients who require therapeutic drainage. Early detection and treatment of these risk factors may improve results.

Source:

Saqib, M., Iqbal, N., Saqib, A., & Khan, S. (2026). Risk factors of pleural effusion in post-liver transplant pediatric population. Pakistan Journal of Medical Sciences, 42(4), 1012-1018. https://doi.org/10.12669/pjms.42.4.14742