{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:38:11Z","timestamp":1790743091122,"version":"4.1.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K01DK101677"],"award-info":[{"award-number":["K01DK101677"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K24DK101828"],"award-info":[{"award-number":["K24DK101828"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["5K08HS023876-02"],"award-info":[{"award-number":["5K08HS023876-02"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>The increased use of split\u2010liver transplantation (SLT) represents a strategy to increase the supply of organs. Although outcomes after SLT and whole liver transplantation (WLT) are similar on average among pediatric recipients, we hypothesized that the relationship between graft type and outcomes may vary depending on patient, donor, and surgical characteristics. We evaluated graft survival among pediatric (&lt;18 years) deceased donor, liver\u2010only transplant recipients from March 2002 until December 2015 using data from the Scientific Registry of Transplant Recipients. Graft survival was assessed in a Cox proportional hazards model, with and without effect modification between graft type and donor, recipient, and surgical characteristics, to identify conditions where the risk of graft loss for SLT and WLT were similar. In a traditional multivariable model, characteristics associated with graft loss included donor age &gt;50 years, recipient weight &lt;10 kg, acute hepatic necrosis, autoimmune diseases, tumor, public insurance, and cold ischemia time (CIT) &gt;8 hours. In an analysis that explored whether these characteristics modified the relationship between graft type and graft loss, many characteristics associated with loss actually had similar outcomes regardless of graft type, including weight &lt;10 kg, acute hepatic necrosis, autoimmune diseases, and tumor. In contrast, several subgroups had worse outcomes when SLT was used, including recipient weight 10\u201035 kg, non\u2013biliary atresia cholestasis, and metabolic disease. Allocation score, share type, or CIT did not modify risk of graft type and graft failure. Although one might anticipate that individuals with higher rates of graft loss would be worse candidates for SLT, data suggest that these patients actually have similar rates of graft loss. These findings can guide surgical decision making and may support policy changes that promote the increased use of SLT for specific pediatric recipients.<\/jats:p>","DOI":"10.1002\/lt.25340","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T10:33:25Z","timestamp":1537353205000},"page":"119-127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Expansion of the Liver Donor Supply Through Greater Use of Split\u2010Liver Transplantation: Identifying Optimal Recipients"],"prefix":"10.1097","volume":"25","author":[{"given":"Douglas B.","family":"Mogul","sequence":"first","affiliation":[{"name":"Department of Pediatrics, School of Medicine,Bloomberg School of Public Health, Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine,Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Garonzik\u2010Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine,Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary G.","family":"Bowring","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine,Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan B.","family":"Massie","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine,Johns Hopkins University,Baltimore,MD"},{"name":"Department of Epidemiology,Bloomberg School of Public Health, Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen B.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine,Bloomberg School of Public Health, Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine,Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F. P.","family":"Bridges","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management,Bloomberg School of Public Health, Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine,Johns Hopkins University,Baltimore,MD"},{"name":"Department of Epidemiology,Bloomberg School of Public Health, Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,1,4]]},"reference":[{"issue":"suppl 1","key":"lt25340-bib-0001-20240115","first-page":"174","article-title":"OPTN\/SRTR 2015 Annual Data Report: Liver","volume":"17","year":"2017","journal-title":"Am J Transplant"},{"key":"lt25340-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1053\/j.gastro.2017.06.053","article-title":"Analysis of liver offers to pediatric candidates on the transplant wait list","volume":"153","year":"2017","journal-title":"Gastroenterology"},{"key":"lt25340-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/lt.24646","article-title":"Global lessons in graft type and pediatric liver allocation: a path toward improving outcomes and eliminating wait\u2010list mortality","volume":"23","year":"2017","journal-title":"Liver Transpl"},{"key":"lt25340-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jpeds.2017.11.015","article-title":"Fifteen\u2010year trends in pediatric liver transplants: split, whole deceased, and living donor grafts","volume":"196","year":"2018","journal-title":"J Pediatr"},{"key":"lt25340-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/j.jamcollsurg.2013.06.005","article-title":"Deceased\u2010donor split\u2010liver transplantation in adult recipients: is the learning curve over?","volume":"217","year":"2013","journal-title":"J Am Coll Surg"},{"key":"lt25340-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jamcollsurg.2013.03.003","article-title":"Outcomes with split liver transplantation are equivalent to those with whole organ transplantation","volume":"217","year":"2013","journal-title":"J Am Coll Surg"},{"key":"lt25340-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1002\/hep.21888","article-title":"Minimizing risk associated with elderly liver donors by matching to preferred recipients","volume":"46","year":"2007","journal-title":"Hepatol"},{"key":"lt25340-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/SLA.0b013e31821ad86a","article-title":"A multivariate analysis of pre\u2010, peri\u2010, and post\u2010transplant factors affecting outcome after pediatric liver transplantation","volume":"254","year":"2011","journal-title":"Ann Surg"},{"key":"lt25340-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/j.1600-6143.2006.01242.x","article-title":"Characteristics associated with liver graft failure: the concept of a donor risk index","volume":"6","year":"2006","journal-title":"Am J Transplant"},{"key":"lt25340-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1111\/ajt.12777","article-title":"Big data in organ transplantation: registries and administrative claims","volume":"14","year":"2014","journal-title":"Am J Transplant"},{"key":"lt25340-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/SLA.0b013e3180caa415","article-title":"Song C; for SPLIT Research Group. Impact of graft type on outcome in pediatric liver transplantation: a report from Studies of Pediatric Liver Transplantation (SPLIT)","volume":"246","year":"2007","journal-title":"Ann Surg"},{"key":"lt25340-bib-0012-20240115","first-page":"1","article-title":"Effective communication of standard errors and confidence intervals","volume":"10","year":"2009","journal-title":"Biostatistics"},{"key":"lt25340-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1002\/lt.21491","article-title":"Analysis of recent pediatric orthotopic liver transplantation outcomes indicates that allograft type is no longer a predictor of survivals","volume":"14","year":"2008","journal-title":"Liver Transpl"},{"key":"lt25340-bib-0014-20240115","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/00007890-200207270-00006","article-title":"for Principal Investigators and Institutions of the Studies of Pediatric Liver Transplantation (SPLIT) Research Group. Development of a pediatric end\u2010stage liver disease score to predict poor outcome in children awaiting liver transplantation","volume":"74","year":"2002","journal-title":"Transplantation"},{"key":"lt25340-bib-0016-20240115","article-title":"Split liver transplantation and pediatric waitlist mortality in the United States: potential for improvement","year":"2018","journal-title":"Transplantation"},{"key":"lt25340-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/TP.0b013e3181ba1096","article-title":"Conventional split liver transplantation for two adult recipients: a recent experience in a single European center","volume":"88","year":"2009","journal-title":"Transplantation"},{"key":"lt25340-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1002\/lt.24015","article-title":"Vasculobiliary complications following adult right lobe split liver transplantation from the perspective of reconstruction techniques","volume":"21","year":"2015","journal-title":"Liver Transpl"},{"key":"lt25340-bib-0019-20240115","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1002\/bjs.8755","article-title":"Comparison of liver transplantation outcomes from adult split liver and circulatory death donors","volume":"99","year":"2012","journal-title":"Br J Surg"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.25340","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.25340","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.25340","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201901000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T01:28:27Z","timestamp":1705282107000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201901000-00017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.25340","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}