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Role of serum miR-122 and miR-21 for predicting early acute lung injury after pediatric liver transplantation:A retrospective case-control study


      Background: Acute lung injury(ALI) is a complicated disease with high morbidity and mortality for pediatric after living donor liver transplant (LDLT), the identification of effective prediction model involved in ALI is urgent and highly demanded. Methods: Perioperative data of patients were obtained through the electronic medical records system. Patients were divided into non-ALI group and ALI group according according to whether ALI occurred in the first week after surgery.The main measure was serum miR-122 and miR-21 levels after anesthesia induction(T1), 10min of anhepatic phase(T2), 30min of neohepatic phase (T3) and directly after surgery(T4). Lung ultrasound examination was performed three times at 24 h before LDLT, 24h and 72h after LDLT. Multiple logistic regression analysis of preoperative factors was conducted to screen the risk factors of ALI, and the predictive value of risk factors was evaluated by ROC curve.Lung ultrasound score(LUS) after LDLT was used to compare the pulmonary complications between two groups. Results: A total of 90 patients were included, including 53 in the non-ALI group and 37 in the ALI group. Increased intraoperative blood transfusion volume,TNF-α at T3, miR-122 at T4 and miR-21 at T4 were related factors for the occurrence of ALI.( P<0.05), the AUC of the combination in predicting early ALI was 0.918(0.876–0.987). The LUS of pulmonary consolidation and pulmonary edema were higher in ALI group. Conclusion: Increased intraoperative blood transfusion, TNF-α, miR-122 and miR-21 levels are independent risk factors for ALI after LDLT, the LUS of pulmonary complications was higher in ALI group, paying attention to these indicators can improve the efficacy of pediatric respiratory management after LDLT. Trial registration: www.chictr.org.cn/ identifier: ChiCTR2200059722.