{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:35:13Z","timestamp":1780047313571,"version":"3.53.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2017,10,26]],"date-time":"2017-10-26T00:00:00Z","timestamp":1508976000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,10,26]],"date-time":"2017-10-26T00:00:00Z","timestamp":1508976000000},"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":[[2017,11]]},"abstract":"<jats:p>Cirrhosis in adults is associated with modifications of systemic and liver hemodynamics, whereas little is known about the pediatric population. The aim of this work was to investigate whether alterations of hepatic and systemic hemodynamics were correlated with cirrhosis severity in children. The impact of hemodynamic findings on surgical management in pediatric living donor liver transplantation (LT) was evaluated. Liver and systemic hemodynamics were studied prospectively in 52 children (median age, 1 year; 33 with biliary atresia [BA]). The hemodynamics of native liver were studied preoperatively by Doppler ultrasound and intraoperatively using invasive flowmetry. Portosystemic gradient was invasively measured. Systemic hemodynamics were studied preoperatively by Doppler transthoracic echocardiography and intraoperatively by using transpulmonary thermodilution. Hemodynamic parameters were correlated with Pediatric End\u2010Stage Liver Disease (PELD) score and the histological degree of fibrosis (collagen proportionate area [CPA]). Cirrhosis was associated with a 60% reduction of pretransplant total liver flow (n\u2009=\u200946; median, 36\u2009mL\/minute\/100\u2009g of liver) compared with noncirrhotic livers (n\u2009=\u20096; median, 86\u2009mL\/minute\/100\u2009g; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.002). Total blood flow into the native liver was negatively correlated with PELD (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001) and liver CPA (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.005). Median portosystemic gradient was 14.5\u2009mm Hg in children with cirrhosis and positively correlated with PELD (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001). Portal vein (PV) hypoplasia was observed mainly in children with BA (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02). Systemic hemodynamics were not altered in our children with cirrhosis. Twenty\u2010one children met the intraoperative criteria for PV reconstruction using a portoplasty technique during the LT procedure and had a smaller PV diameter at pretransplant Doppler ultrasound (median\u2009=\u20093.4\u2009mm; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001). Cirrhosis in children appears also as a hemodynamic disease of the liver, correlated with cirrhosis severity. Surgical technique for PV reconstruction during LT was adapted accordingly. <jats:italic toggle=\"yes\">Liver Transplantation 23 1440\u20131450 2017<\/jats:italic> AASLD.<\/jats:p>","DOI":"10.1002\/lt.24850","type":"journal-article","created":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T16:06:37Z","timestamp":1502985997000},"page":"1440-1450","source":"Crossref","is-referenced-by-count":21,"title":["Liver and systemic hemodynamics in children with cirrhosis: Impact on the surgical management in pediatric living donor liver transplantation"],"prefix":"10.1097","volume":"23","author":[{"given":"Catherine","family":"de Magn\u00e9e","sequence":"first","affiliation":[{"name":"Pediatric Surgery and Transplantation Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Veyckemans","sequence":"additional","affiliation":[{"name":"Anaesthesiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Pirotte","sequence":"additional","affiliation":[{"name":"Anaesthesiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Menten","sequence":"additional","affiliation":[{"name":"Pediatric Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Dumitriu","sequence":"additional","affiliation":[{"name":"Pediatric Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Clapuyt","sequence":"additional","affiliation":[{"name":"Pediatric Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karlien","family":"Carbonez","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Cliniques Universitaires St. Luc, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Barrea","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Cliniques Universitaires St. Luc, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Sluysmans","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Cliniques Universitaires St. Luc, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Sempoux","sequence":"additional","affiliation":[{"name":"Institute of Pathology,Centre Hospitalier Universitaire Vaudois,Lausanne,Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Leclercq","sequence":"additional","affiliation":[{"name":"Laboratory of Hepato\u2010Gastroenterology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Zech","sequence":"additional","affiliation":[{"name":"Institute of Experimental and Clinical Research,Universit\u00e9 Catholique de Louvain,Brussels,Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Stephenne","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology,Cliniques Universitaires St. Luc,Brussels,Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Reding","sequence":"additional","affiliation":[{"name":"Pediatric Surgery and Transplantation Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,10,26]]},"reference":[{"key":"lt24850-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"347","DOI":"10.3350\/kjhep.2010.16.4.347","article-title":"Hemodynamic alterations in cirrhosis and portal hypertension","volume":"16","year":"2010","journal-title":"Korean J Hepatol"},{"key":"lt24850-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/j.gastro.2011.06.082","article-title":"Cardiac structural and functional alterations in infants and children with biliary atresia, listed for liver transplantation","volume":"141","year":"2011","journal-title":"Gastroenterology"},{"key":"lt24850-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1111\/j.1399-3046.2012.01667.x","article-title":"Evaluation of cardiac manifestations in pediatric liver transplant candidates","volume":"16","year":"2012","journal-title":"Pediatr Transplant"},{"key":"lt24850-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s10024-003-0307-y","article-title":"Biliary atresia revisited","volume":"7","year":"2004","journal-title":"Pediatr Dev Pathol"},{"issue":"pt 2","key":"lt24850-bib-0005-20240115","first-page":"41S","article-title":"Sequential treatment of biliary atresia with Kasai portoenterostomy and liver transplantation: a review","volume":"20","year":"1994","journal-title":"Hepatology"},{"key":"lt24850-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1002\/hep.510230652","article-title":"Biliary atresia: current concepts and research directions. 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