{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:58:04Z","timestamp":1789232284221,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"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":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of neonatal portal vein thrombosis (PVT), a relatively common type of pediatric deep vein thrombosis, is not completely standardized. Questions remain about the benefit of anticoagulation (ATC) therapy and about the optimal frequency and duration of doppler ultrasound (US) surveillance for liver complications such as portal hypertension and gastrointestinal bleeding. Current guidelines suggest reserving ATC only for occlusive PVT, highlighting a need for explicit grading of PVT in radiologic reports and a consensus approach to imaging and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To address these issues, we implemented an institutional Neonatal PVT Management Algorithm using plan\u2013do\u2013study\u2013act (PDSA) methodology. We aimed to standardize screening tests, reduce unnecessary ATC, and optimize imaging checkpoints. A five\u2010year retrospective review established baseline data, which we compared to outcomes five years post\u2010implementation of the algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The algorithm recommended ATC only for occlusive PVT and advised US imaging at Week 1, Month 1, Month 3, and Month 6 from diagnosis, with annual surveillance for unresolved or abnormal cases. Post\u2010implementation analysis revealed improvements in radiologic documentation of PVT grading, a reduction in the use of ATC for subocclusive PVT, and a decrease in the median duration of ATC for all patients. Follow\u2010up imaging adherence did not improve between the pre\u2010 and post\u2010implementation periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The algorithm successfully enhanced documentation of PVT grading and reduced unnecessary ATC but highlighted persistent challenges in follow\u2010up adherence, suggesting a need for further refinement in future PDSA cycles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.31589","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T10:35:42Z","timestamp":1739356542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neonatal Portal Vein Thrombosis: A Retrospective Study of Management and Follow\u2010Up at One Institution"],"prefix":"10.1002","volume":"72","author":[{"given":"Suhani","family":"Jain","sequence":"first","affiliation":[{"name":"Grant Government Medical College and Sir JJ Group of Hospitals  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Maurer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Hematology\/Oncology Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"University of Pittsburgh School of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Hematology\/Oncology Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"University of Pittsburgh School of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Correa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Hematology\/Oncology Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"McCormick","sequence":"additional","affiliation":[{"name":"Grant Government Medical College and Sir JJ Group of Hospitals  Mumbai India"},{"name":"Department of Pediatrics Division of Hematology\/Oncology Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Devine","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania 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