{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T18:11:52Z","timestamp":1790446312003,"version":"4.1.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T00:00:00Z","timestamp":1658016000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/ http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K08DK121937"],"award-info":[{"award-number":["1K08DK121937"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Neonatal acute liver failure (ALF) carries a high mortality rate; however, little data exist on its peritransplant hospital course. This project aimed to identify factors associated with outcomes in neonates with ALF using large multicenter databases. Patients with International Classification of Diseases, Ninth Revision\/International Classification of Diseases, Tenth Revision codes for liver failure (2004\u20132018) from linked Pediatric Health Information System and Scientific Registry of Transplant Recipients databases were assigned to two groups: neonates aged \u226430\u2009days or older infants aged 31\u2013120\u2009days at admission. Billing data were used to assign diagnoses and assess patient comorbidities (sepsis, extracorporeal membrane oxygenation, total parenteral nutrition, intensive care unit, and cardiac\/renal\/respiratory failure). Statistical analysis included Kaplan\u2013Meier survival curve analysis and univariate and multivariate analyses with the Cox proportional hazards model. We identified 1807 neonates and 890 older infants. Neonates had significantly lower survival to 90\u2009days (<jats:italic toggle=\"yes\">p<\/jats:italic> =\u20090.04) and a lower rate of liver transplantation (2.0% vs. 6.4%; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt;\u20090.001). Common risk factors associated with death or transplant were present between groups: diagnosis, respiratory failure, cardiac failure, and renal failure. Among neonates versus older infants who received a transplant, there was no significant differences in posttransplant lengths of stay (median 38 vs. 32\u2009days; <jats:italic toggle=\"yes\">p<\/jats:italic> =\u20090.53), posttransplant mortality (15% vs. 11%; <jats:italic toggle=\"yes\">p<\/jats:italic> =\u20090.66), or graft loss (9.7% vs. 8.1%; <jats:italic toggle=\"yes\">p<\/jats:italic> =\u20090.82). We present the largest multicenter study on peritransplant outcomes in neonatal ALF and show similar risk factors for death or transplant in neonates compared with older infants. Despite lower transplantation rates, neonates demonstrate similar posttransplant outcomes as older infants. Further studies are needed to better risk stratify neonates eligible for transplant and improve outcomes.<\/jats:p>","DOI":"10.1002\/lt.26537","type":"journal-article","created":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T12:18:56Z","timestamp":1656159536000},"page":"5-14","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Neonates with acute liver failure have higher overall mortality but similar posttransplant outcomes as older infants"],"prefix":"10.1097","volume":"29","author":[{"given":"Swati","family":"Antala","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Godown","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Hall","sequence":"additional","affiliation":[{"name":"Children's Hospital Association, Lenexa, Kansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Banc\u2010Husu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estella M.","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3575-8386","authenticated-orcid":false,"given":"Sarah A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,7,17]]},"reference":[{"key":"R1-20250501","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/lt.24433","article-title":"Neonatal acute liver failure","volume":"22","year":"2016","journal-title":"Liver Transpl"},{"key":"R2-20250501","first-page":"e26","article-title":"Liver failure among young Saudi infants: etiology, clinical presentation, and outcome","volume":"70","year":"2020","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R3-20250501","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1002\/hep.31109","article-title":"Liver diseases in the perinatal period: interactions between mother and infant","volume":"71","year":"2020","journal-title":"Hepatology"},{"key":"R4-20250501","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.clp.2019.10.006","article-title":"Neonatal acute liver failure","volume":"47","year":"2020","journal-title":"Clin Perinatol"},{"key":"R5-20250501","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/MPG.0000000000003103","article-title":"Applying an age\u2010specific definition to better characterize etiologies and outcomes in neonatal acute liver failure","volume":"73","year":"2021","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R6-20250501","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.earlhumdev.2005.10.003","article-title":"Acute liver failure in neonates","volume":"81","year":"2005","journal-title":"Early Hum Dev"},{"key":"R7-20250501","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1097\/MPG.0b013e318175d7d2","article-title":"Outcomes after liver transplantation in young infants","volume":"47","year":"2008","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R8-20250501","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1002\/lt.25619","article-title":"Outcomes of liver transplantation in small infants","volume":"25","year":"2019","journal-title":"Liver Transpl"},{"key":"R9-20250501","article-title":"Expanding analytic possibilities in pediatric solid organ transplantation through linkage of administrative and clinical registry databases","volume":"23","year":"2019","journal-title":"Pediatr Transplant"},{"key":"R10-20250501","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":"R11-20250501","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1002\/lt.24743","article-title":"Living donor liver transplantation during the first 3 months of life","volume":"23","year":"2017","journal-title":"Liver Transpl"},{"key":"R12-20250501","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/j.1399-3046.2011.01541.x","article-title":"ABO\u2010incompatible pediatric liver transplantation in very small recipients: Birmingham's experience","volume":"15","year":"2011","journal-title":"Pediatr Transplant"},{"key":"R13-20250501","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1053\/jpsu.2002.30242","article-title":"Techniques for and outcome of liver transplantation in neonates and infants weighing up to 5 kilograms","volume":"37","year":"2002","journal-title":"J Pediatr Surg"},{"key":"R14-20250501","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1002\/lt.24501","article-title":"Prognostic modeling in pediatric acute liver failure","volume":"22","year":"2016","journal-title":"Liver Transpl"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.26537","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.26537","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/lt.26537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T16:01:03Z","timestamp":1746115263000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/lt.26537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,17]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.26537","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2022,7,17]]},"assertion":[{"value":"2022-04-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}