Background Living donor liver transplantation (LDLT) remains the only curative treatment for children with end-stage liver disease; however, complications of the procedure are associated with indications for early relaparotomy. Several risk factors associated with early relaparotomy after liver transplantation include pediatric end-stage liver disease (PELD) score, warm ischemia time (WIT), and cold ischemia time (CIT). Our study investigated the incidence and indications of early relaparotomy in postoperative pediatric LDLT recipients and compared the outcomes with patients who did not require relaparotomy. Methods A retrospective cohort study of pediatric LDLT recipients from Cipto Mangunkusumo Hospital, Jakarta, Indonesia, was collected from 2010 to August 2022. Indications for early relaparotomy were investigated. Factors analyzed in the early relaparotomy group compared with the nonrelaparotomy group included intraoperative blood loss, surgery duration, CIT, WIT, and PELD score. Results The highest indication for early relaparotomy was biliary leakage. Most patients who underwent early relaparotomy only had one incidence of relaparotomy (60%). The surgery duration in subjects with early relaparotomy was longer by a median of 3 hours compared with those without early relaparotomy (p=0.289). Intraoperative blood loss was greater in early relaparotomy subjects than in subjects without early relaparotomy (95 vs 77 mL/kg, p=0.552). Other factors, such as PELD score, CIT, and WIT, also showed no significant difference between the two groups. Conclusion Biliary leakage was the most common indication for early relaparotomy in our center. There were no preoperative or intraoperative factors that significantly influenced the incidence of early relaparotomy due to the limited sample size and the early advancement of our liver transplant center. Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

---

小儿活体肝移植后的早期再次剖腹手术：印度尼西亚国家转诊医院的经验

背景 活体肝移植 (LDLT) 仍然是治疗终末期肝病儿童的唯一方法。然而，该手术的并发症与早期再次剖腹手术的指征有关。与肝移植后早期再次剖腹手术相关的几个危险因素包括儿科终末期肝病 (PELD) 评分、热缺血时间 (WIT) 和冷缺血时间 (CIT)。我们的研究调查了术后儿童 LDLT 接受者早期再次开腹手术的发生率和适应症，并将结果与​​不需要再次开腹手术的患者进行了比较。方法 收集了 2010 年至 2022 年 8 月印度尼西亚雅加达 Cipto Mangunkusumo 医院儿科 LDLT 接受者的回顾性队列研究。调查了早期再剖腹手术的指征。与非再开腹组相比，早期再开腹组分析的因素包括术中失血量、手术持续时间、CIT、WIT 和 PELD 评分。结果 早期再次剖腹手术的最高指征是胆漏。大多数接受早期再开腹手术的患者只有一次再开腹手术的发生率 (60%)。与没有早期再次剖腹手术的受试者相比，早期再次剖腹手术受试者的手术持续时间中位数长 3 小时 (p=0.289)。早期再开腹手术受试者的术中失血量高于未进行早期再开腹手术的受试者（95 vs 77 mL/kg，p=0.552）。其他因素，如 PELD 评分、CIT 和 WIT，也显示两组之间没有显着差异。结论 胆漏是我中心早期再次开腹最常见的指征。由于样本量有限和我们肝移植中心的早期进展，没有术前或术中因素显着影响早期再次开腹的发生率。可应合理要求提供数据。所有与研究相关的数据都包含在文章中或作为补充信息上传。