Tesis

Prevalens dan Faktor Risiko Gangguan Natrium, Kalium, dan Klorida Pascatransplantasi Hati Anak di Rumah Sakit Umum DR. Cipto Mangunkusumo = Prevalens and Risk Factors of Sodium, Potassium, and Chloride Imbalance in Children Post Liver Transplantation at DR. Cipto Mangunkusumo Hospital.

Latar belakang: Kompleksitas operasi transplantasi hati dapat mengakibatkan terjadinya gangguan elektrolit utama tubuh seperti natrium, kalium dan klorida. Ketidakseimbangan elektrolit menyebabkan buruknya prognosis pasien pasca-operasi karena berkaitan dengan kejadian morbiditas seperti gangguan hemodinamik, gangguan neurologis (ensefalopati, kejang, central pontine myelinolysis), dan bahkan kematian. Belum adanya penelitian yang menggambarkan prevalens dan penilaian faktor risiko gangguan elektrolit pada populasi pediatri di Indonesia. Penelitian ini dilakukan untuk melihat prevalens dan menilai faktor risiko terjadinya gangguan elektrolit pada pasien anak pascatransplantasi hati di pusat transplantasi hati Rumah Sakit Cipto Mangunkusumo, Jakarta Indonesia. Metode: Studi kohort retrospektif yang dilakukan di pusat transplantasi hati RSCM Jakarta, Indonesia dan melibatkan seluruh pasien anak yang menjalani transplantasi hati pada periode Desember 2010 sampai Desember 2023. Penilaian bivariat dan multivariat dilakukan untuk menilai faktor risiko yang berhubungan dengan gangguan elektolit pascatransplantasi hati. Hasil: Sebanyak 78 subyek memenuhi kriteria inklusi dengan 79,5% diantaranya mengalami gangguan elektrolit. Indikasi operasi transplantasi hati terbanyak adalah atresia bilier (79,5%). Faktor risiko yang berpengaruh terhadap gangguan elektrolit pada pasien anak pasca operasi transplantasi hati adalah durasi operasi lebih dari 12 jam (RR 1,46 IK 95% 1,21 -1,54) dan kreatinin serum (RR 0,64 IK 95% 0,27-0,98) dengan nilai p < 0,05. Kesimpulan: Sebagian besar pasien anak yang menjalani operasi transplantasi hari mengalami gangguan elektrolit. Durasi operasi lebih dari 12 jam dan peningkatan nilai kreatinin serum berhubungan dengan kejadian gangguan elektrolit.
Kata Kunci: Gangguan elektrolit,pascatransplantasi hati, anak, pediatri


Background: The complexity of liver transplantation surgery can lead to major electrolyte disturbances such as sodium, potassium, and chloride. Electrolyte disturbances can result in poor postoperative patient prognosis due to the association with morbidity events such as hemodynamic disorders, neurological disorders (encephalopathy, seizures, central pontine myelinolysis), and even death. There are no studies that describe the prevalence and risk factors of electrolyte disturbances in the pediatric population in Indonesia.This study was conducted to observe the prevalence and assess the risk factors for electrolyte disturbances in pediatric patients after liver transplantation at the Cipto Mangunkusumo Hospital Liver Transplant Center, Jakarta, Indonesia. Method: Retrospective cohort study conducted at a liver transplant center in Jakarta, Indonesia, involving all pediatric patients who underwent liver transplantation from December 2010 to December 2023. Bivariate and multivariate assessments were performed to evaluate the risk factors associated with post-liver transplantation electrolyte disturbances. Results: A total of 78 subjects met the inclusion criteria, with 79.5% experiencing electrolyte disturbances. The most common indication for liver transplantation surgery was biliary atresia (79.5%). The risk factors affecting electrolyte disturbances in pediatric patients after liver transplantation surgery were operation duration more than 12 hours (RR 1.46, 95% CI 1.21 -1.54) and serum creatinine (RR 0.64, 95% CI 0.27-0.98) with a p-value < 0.05. Conclusion: Most pediatric patients undergoing liver transplantation experience electrolyte disturbances. An operation duration of more than 12 hours and an increase in serum creatinine levels are associated with the occurrence of electrolyte disturbances.
Keywords: Electrolyte imbalance, post-liver transplantation, children, pediatrics