{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:21:51Z","timestamp":1788348111410,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2017,8,21]],"date-time":"2017-08-21T00:00:00Z","timestamp":1503273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,8,21]],"date-time":"2017-08-21T00:00:00Z","timestamp":1503273600000},"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":[[2017,9]]},"abstract":"<jats:p>After decades of dramatic surgical innovations in pediatric living donor liver transplantation (LDLT), LDLT for biliary atresia (BA) still poses various challenges. This study reviewed our experience with LDLT for children with post\u2010Kasai BA and evaluated outcomes and prognostic factors. From 2005 to 2016, 168 post\u2010Kasai BA LDLT patients were enrolled and divided into 3 groups by age. Patient characteristics and perioperative data were compared. Predictors of morbidity and mortality following LDLT were analyzed in 93 infants. Outcome was relatively worse in infants than older children, with overall survival at 1 and 5 years of 94.5% and 93.2%, respectively, and graft survival at 1 and 5 years of 91.1% each. Incidence of vascular complications was not significantly higher in infants. High Pediatric End\u2010Stage Liver Disease (PELD) score (odds ratio [OR], 3.72; 95% confidence interval [CI], 1.30\u201010.67; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02) and portal vein (PV) hypoplasia (OR, 3.23; 95% CI, 1.10\u20109.52; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.03) were independent risk factors for morbidity. Low weight\u2010for\u2010age <jats:italic toggle=\"yes\">z<\/jats:italic> score (hazard ratio, 5.76; 95% CI, 1.05\u201031.47; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.03) was identified as a significant risk factor for mortality after LDLT, but not age or absolute body weight (BW). Infants with BW deficit had a significantly smaller PV diameter (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.005), greater blood loss (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.001), and higher incidence of postoperative bacteremia (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.01). In conclusion, high PELD score and PV hypoplasia were independent risk factors for morbidity, and BW deficit was associated with poor survival in infants with post\u2010Kasai BA after LDLT. However, LDLT in these infants at the earliest possible time after referral is a feasible option with excellent patient survival in an experienced center. <jats:italic toggle=\"yes\">Liver Transplantation 23 1199\u20131209 2017<\/jats:italic> AASLD.<\/jats:p>","DOI":"10.1002\/lt.24796","type":"journal-article","created":{"date-parts":[[2017,6,7]],"date-time":"2017-06-07T16:44:40Z","timestamp":1496853880000},"page":"1199-1209","source":"Crossref","is-referenced-by-count":27,"title":["Living donor liver transplantation for post\u2010Kasai biliary atresia: Analysis of pretransplant predictors of outcomes in infants"],"prefix":"10.1097","volume":"23","author":[{"given":"Toshihiro","family":"Kitajima","sequence":"first","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"},{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine,Kyoto University,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seisuke","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Uchida","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichi","family":"Narumoto","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinari","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Teramukai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Graduate School of Medical Science,Kyoto Prefectural University of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Uemoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine,Kyoto University,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mureo","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,8,21]]},"reference":[{"key":"lt24796-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1016\/S0140-6736(09)60946-6","article-title":"Biliary atresia","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"lt24796-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1001\/archsurg.1996.01430170039006","article-title":"Long\u2010term results with the Kasai operation for biliary atresia","volume":"131","year":"1996","journal-title":"Arch Surg"},{"key":"lt24796-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/MOP.0000000000000214","article-title":"Recent advances in the pathogenesis and management of biliary atresia","volume":"27","year":"2015","journal-title":"Curr Opin Pediatr"},{"key":"lt24796-bib-0004-20240115","first-page":"E100","article-title":"Living donor liver transplantation with alternative porto\u2010left gastric vein anastomosis in patients with post\u2010Kasai extrahepatic portal vein obstruction","volume":"17","year":"2013","journal-title":"Pediatr Transplant"},{"key":"lt24796-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jpedsurg.2011.09.036","article-title":"Portal vein reconstruction in pediatric living donor liver transplantation for patients younger than 1 year with biliary atresia","volume":"47","year":"2012","journal-title":"J Pediatr Surg"},{"key":"lt24796-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/00000658-199609000-00004","article-title":"Orthotopic liver transplantation for congenital biliary atresia. An 11\u2010year, single\u2010center experience","volume":"224","year":"1996","journal-title":"Ann Surg"},{"key":"lt24796-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1097\/01.TP.0000062570.83203.A3","article-title":"Pediatric liver transplantation for biliary atresia: results of primary grafts in 328 recipients","volume":"75","year":"2003","journal-title":"Transplantation"},{"key":"lt24796-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1002\/lt.20358","article-title":"Long\u2010term outcome of pediatric liver transplantation for biliary atresia: a 10\u2010year follow\u2010up in a single center","volume":"11","year":"2005","journal-title":"Liver Transpl"},{"key":"lt24796-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jpeds.2005.04.073","article-title":"Biliary atresia: clinical profiles, risk factors, and outcomes of 755 patients listed for liver 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