{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:21:52Z","timestamp":1788348112965,"version":"build-2803163510"},"reference-count":66,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2016,8,24]],"date-time":"2016-08-24T00:00:00Z","timestamp":1471996800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,8,24]],"date-time":"2016-08-24T00:00:00Z","timestamp":1471996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>This review presents the author's personal perspective and contributions to the first steps, the development, the current status, and the remaining issues of pediatric liver transplantation (LT). Innumerable children around the world who have undergone LT have reached adulthood. The techniques have reached maturity. As shown by my own group's experience, grafts donated by living donors might provide the best short\u2010term and longterm results. Debate persists about the optimal immunosuppression (IS), although the place of tacrolimus remains unchallenged. Tolerance induction protocols aiming to induce microchimerism have been tried in clinical transplantation without convincing results. Withdrawal of maintenance IS is possible in some children who underwent liver transplantation who have excellent clinical status and normal liver function tests but is not without risk of rejection and subsequent worsening of histology. The current trend favored by the Brussels' group is to minimize IS as soon after transplant as possible, aiming to obtain a state of \u201cprope\u201d or \u201calmost\u201d tolerance. Liver grafts are threatened in the long term by increasing hepatitis\u2010related fibrosis, resulting most likely from immunological assault. Nowadays, the focus is on the longterm survival, quality of life (growth, academic performance, employment, self\u2010fulfillment, fertility, raising a family, etc.), induction of tolerance, prevention of risks bound to decades of IS (nephrotoxicity and neurotoxicity, cardiovascular risk, de novo malignancies, etc.), and prevention of graft fibrosis. All these issues are fertile fields for younger scientists.<jats:italic toggle=\"yes\">Liver Transplantation 22 1284\u20131294 2016 AASLD<\/jats:italic><\/jats:p>","DOI":"10.1002\/lt.24470","type":"journal-article","created":{"date-parts":[[2016,4,21]],"date-time":"2016-04-21T07:52:12Z","timestamp":1461225132000},"page":"1284-1294","source":"Crossref","is-referenced-by-count":31,"title":["Pediatric liver transplantation: Personal perspectives on historical achievements and future challenges"],"prefix":"10.1097","volume":"22","author":[{"given":"Jean\u2010Bernard","family":"Otte","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery and Liver Transplantation, Cliniques Saint\u2010Luc,Universit\u00e9 Catholique de Louvain,Brussels,Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,8,24]]},"reference":[{"key":"lt24470-bib-0002-20240115","first-page":"3256","article-title":"Pediatric liver transplantation: Cambridge\/King's series, December 1983 to August 1986","volume":"4","year":"1987","journal-title":"Transplant Proc"},{"key":"lt24470-bib-0003-20240115","first-page":"263","article-title":"La transplantation d'organes","volume":"4","year":"1972","journal-title":"La Nouvelle Presse M\u00e9dicale"},{"issue":"suppl","key":"lt24470-bib-0004-20240115","first-page":"107S","article-title":"National Institutes of Health Consensus Development Conference statement: liver transplantation\u2010\u2010June 20\u201023, 1983","volume":"4","year":"1984","journal-title":"Hepatology"},{"key":"lt24470-bib-0005-20240115","first-page":"3229","article-title":"Liver transplantation in children","volume":"19","year":"1987","journal-title":"Transplant Proc"},{"key":"lt24470-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1034\/j.1399-3046.2002.01082.x","article-title":"History of pediatric liver transplantation: Where are we coming from. 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