{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:03:23Z","timestamp":1786118603030,"version":"build-2736575974"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T00:00:00Z","timestamp":1566000000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>In liver transplantation (LT) for biliary atresia (BA) with situs inversus (SI), the surgical procedure is technically challenging due to multiple anatomical variations. We evaluated the surgical procedures and the outcomes in our patients and in the previously reported patients undergoing LT for BA with SI. Between November 2005 and October 2018, 235 children underwent LT with an overall 10\u2010year graft survival of 94.7%. Of these, 6 (2.6%) patients received LT for BA with SI. Living donor liver transplantation (LDLT) was applied in all patients. Vascular anomalies at our center included the absence of the inferior vena cava (IVC; n\u00a0=\u00a05), a preduodenal portal vein (PV; n\u00a0=\u00a04), and an aberrant hepatic artery (HA; n\u00a0=\u00a01). Hepatic vein (HV) outflow obstruction occurred in 1 patient with an absent IVC and necessitated repositioning of the graft immediately after LDLT. PV stenosis occurred in 1 patient with a preduodenal PV at 5\u00a0months after LDLT. The overall survival of our patients was 80.0% at 3\u00a0years. In the literature, 49 patients with LT for BA with SI were reviewed. The survival rate was 91.8%, and the vascular complications included HV outflow obstruction (2.0%), PV complications (10.2%), and HA thrombosis (4.1%). All PV complications occurred in LDLT patients with a preduodenal PV (5\/23; 21.7%). In conclusion, the detailed assessment of the surgical procedures and the systematic literature review demonstrated excellent outcomes after LT for BA with SI. Liver recipients with a preduodenal PV are exposed to a higher risk for vascular complications after a very challenging LT procedure with overall good outcomes.<\/jats:p>","DOI":"10.1002\/lt.25484","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T18:29:02Z","timestamp":1557253742000},"page":"1333-1341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Technical Considerations in Liver Transplantation for Biliary Atresia With Situs Inversus"],"prefix":"10.1097","volume":"25","author":[{"given":"Masahiro","family":"Takeda","sequence":"first","affiliation":[{"name":"Organ Transplantation Center,National Center for Child Health and Development,Tokyo,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":"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":"Shohei","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center,National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center,National Center for Child Health and Development,Tokyo,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Hirata","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":"Andrea","family":"Schlegel","sequence":"additional","affiliation":[{"name":"The Liver Unit,Queen Elizabeth University Hospital,Birmingham,United Kingdom"}],"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":[[2019,8,17]]},"reference":[{"key":"lt25484-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.jpeds.2006.05.030","article-title":"The biliary atresia splenic malformation syndrome: a 28\u2010year single\u2010center retrospective study","volume":"149","year":"2006","journal-title":"J Pediatr"},{"key":"lt25484-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1053\/j.sempedsurg.2012.05.010","article-title":"Biliary atresia: clinical aspects","volume":"21","year":"2012","journal-title":"Semin Pediatr Surg"},{"key":"lt25484-bib-0003-20240115","first-page":"5","article-title":"Liver transplantation in patients with situs inversus","volume":"4","year":"1990","journal-title":"Clin Transplant"},{"key":"lt25484-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1002\/lt.25016","article-title":"A novel technique for collateral interruption to maximize portal venous flow in pediatric liver transplantation","volume":"24","year":"2018","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1002\/lt.20800","article-title":"Vascular reconstruction and complications in living donor liver transplantation in infants weighing less than 6 kilograms: the Kyoto experience","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0006-20240115","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":"lt25484-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy\u2010to\u2010use software \u2018EZR\u2019 for medical statistics","volume":"48","year":"2013","journal-title":"Bone Marrow Transplant"},{"key":"lt25484-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/petr.12703","article-title":"Reno\u2010 and splenoportal anastomosis for a retransplant patient with situs inversus","volume":"20","year":"2016","journal-title":"Pediatr Transplant"},{"key":"lt25484-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/00007890-198803000-00034","article-title":"Liver transplantation in a patient with abdominal situs inversus","volume":"45","year":"1988","journal-title":"Transplantation"},{"key":"lt25484-bib-0010-20240115","first-page":"37","article-title":"Orthotopic liver transplantation in a patient with biliary atresia and abdominal situs inversus","volume":"11","year":"1988","journal-title":"Surg Rounds"},{"key":"lt25484-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/0022-3468(91)90698-S","article-title":"Liver transplantation in children with biliary atresia and polysplenia syndrome","volume":"26","year":"1991","journal-title":"J Pediatr Surg"},{"key":"lt25484-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/j.1432-2277.1993.tb00637.x","article-title":"Liver transplantation in patients with situs inversus","volume":"6","year":"1993","journal-title":"Transpl Int"},{"key":"lt25484-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/lt.500010106","article-title":"Liver transplantation in the presence of situs inversus totalis: application of reduced\u2010size graft","volume":"1","year":"1995","journal-title":"Liver Transpl Surg"},{"key":"lt25484-bib-0014-20240115","first-page":"242","article-title":"Liver transplantation in patients with situs inversus","volume":"82","year":"1995","journal-title":"Br J Surg"},{"key":"lt25484-bib-0015-20240115","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/00000658-199507000-00008","article-title":"Evaluation, operative management, and outcome after liver transplantation in children with biliary atresia and situs inversus","volume":"222","year":"1995","journal-title":"Ann Surg"},{"key":"lt25484-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s003830050452","article-title":"Orthotopic liver transplantation in patients with biliary atresia and situs inversus","volume":"14","year":"1998","journal-title":"Pediatr Surg Int"},{"key":"lt25484-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/j.1432-2277.1998.tb00804.x","article-title":"Situs inversus of donor or recipient in liver transplantation","volume":"11","year":"1998","journal-title":"Transpl Int"},{"key":"lt25484-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1053\/jlts.2001.26923","article-title":"Liver transplantation from situs inversus to situs inversus","volume":"7","year":"2001","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0019-20240115","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1016\/j.transproceed.2004.08.080","article-title":"Case of living donor liver transplantation in a patient with biliary atresia combined with situs inversus","volume":"36","year":"2004","journal-title":"Transplant Proc"},{"key":"lt25484-bib-0020-20240115","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1002\/lt.20584","article-title":"Living donor liver transplantation for biliary atresia complicated by situs inversus: technical highlights","volume":"11","year":"2005","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0021-20240115","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1002\/lt.21583","article-title":"Paralysis in the left phrenic nerve after living\u2010donor liver transplantation for biliary atresia with situs inversus","volume":"14","year":"2008","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0022-20240115","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1002\/lt.23611","article-title":"Technical aspects and outcomes of living donor liver transplantation for pediatric patients with situs inversus","volume":"19","year":"2013","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0023-20240115","first-page":"E274","article-title":"Pediatric split liver transplantation after Fontan procedure in left isomerism combined with biliary atresia: a case report","volume":"18","year":"2014","journal-title":"Pediatr Transplant"},{"key":"lt25484-bib-0024-20240115","doi-asserted-by":"crossref","first-page":"e13218","DOI":"10.1111\/petr.13218","article-title":"\u201cMirror, Mirror on the Wall\u201d\u2026 Pediatric liver transplantation in the case of situs inversus totalis with a disrupted inferior vena cava","volume":"22","year":"2018","journal-title":"Pediatr Transplant"},{"key":"lt25484-bib-0025-20240115","first-page":"bcr\u20102018\u2010226222","article-title":"Living donor liver transplantation and situs inversus totalis: cutting the Gordian knot","volume":"2018","year":"2018","journal-title":"BMJ Case Rep"},{"key":"lt25484-bib-0026-20240115","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1002\/lt.24796","article-title":"Living donor liver transplantation for post\u2010Kasai biliary atresia: analysis of pretransplant predictors of outcomes in infants","volume":"23","year":"2017","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0027-20240115","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1097\/01.TP.0000079446.94204.F9","article-title":"Living\u2010donor liver transplantation with monosegments","volume":"76","year":"2003","journal-title":"Transplantation"},{"key":"lt25484-bib-0028-20240115","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1053\/jlts.2001.22760","article-title":"Living related liver transplantation in biliary atresia with absent inferior vena cava","volume":"7","year":"2001","journal-title":"Liver Transpl"},{"key":"lt25484-bib-0029-20240115","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/S0140-6736(04)16045-5","article-title":"Seamless management of biliary atresia in England and Wales (1999\u20102002)","volume":"363","year":"2004","journal-title":"Lancet"},{"key":"lt25484-bib-0030-20240115","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1016\/j.jpedsurg.2015.08.040","article-title":"Long\u2010term outcomes of biliary atresia with splenic malformation","volume":"50","year":"2015","journal-title":"J Pediatr Surg"},{"key":"lt25484-bib-0031-20240115","doi-asserted-by":"crossref","first-page":"e13118","DOI":"10.1111\/petr.13118","article-title":"Successful management of living donor liver transplantation for biliary atresia with single ventricle physiology\u2010from peri\u2010transplant through total cavopulmonary connection: a case report","volume":"22","year":"2018","journal-title":"Pediatr Transplant"},{"key":"lt25484-bib-0032-20240115","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1097\/01.tp.0000277599.25079.94","article-title":"Living donor liver transplantation in children with congenital heart disease","volume":"84","year":"2007","journal-title":"Transplantation"},{"key":"lt25484-bib-0033-20240115","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1097\/00007890-199903150-00012","article-title":"Long\u2010term outcome of living related liver transplantation for patients with intrapulmonary shunting and strategy for complications","volume":"67","year":"1999","journal-title":"Transplantation"},{"key":"lt25484-bib-0034-20240115","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1002\/lt.25296","article-title":"Hepatopulmonary syndrome in children: a 20\u2010year review of presenting symptoms, clinical progression, and transplant outcome","volume":"24","year":"2018","journal-title":"Liver Transpl"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.25484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.25484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.25484","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/10.1002\/lt.25484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T16:15:18Z","timestamp":1786032918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1002\/lt.25484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,17]]},"references-count":34,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.25484","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,17]]},"assertion":[{"value":"2019-01-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}