Objective To analyze the early complications (within 30 days after operation) and prognostic risk factors after pediatric liver transplantation.

Methods The clinical data of children who underwent liver transplantation in the First Affiliated Hospital of Guangxi Medical University from August 2017 to August 2022 were retrospectively collected. According to the presence or absence of complications, the children were divided into complication group and non-complication group. Univariate and multivariate logistic regression analysis was used to analyze the occurrence and influencing factors of early postoperative complications. The patients were divided into death group and survival group according to the clinical outcomes of hospitalization. Univariate and multivariate Cox regression analysis were used to analyze the risk factors related to clinical outcomes.

Results Among the 160 children after liver transplantation, 106 (66.3%) had early complications, of which the most common complication was infection (52 cases, 32.5%). Multivariate logistic regression analysis showed that the Child-Pugh grade was high in the complication group, and the decrease of eosinophils on d1 after operation was an independent risk factor for early complications in children after liver transplantation (all P < 0.05). Multivariate Cox regression analysis of the risk of death in children after liver transplantation suggested that compared with the survival group, the long operation time, decreased eosinophils, and early complications in the death group were independent risk factors for death in children after liver transplantation (all P < 0.05).

Conclusion The incidence of early complications after liver transplantation in children is high, and the most common complication is infection.Therefore, attention should be paid to the prevention and treatment of infection after liver transplantation. Eosinophil count should be monitored dynamically after pediatric liver transplantation.