{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T17:14:48Z","timestamp":1783185288935,"version":"3.54.6"},"reference-count":0,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2003,3,1]],"date-time":"2003-03-01T00:00:00Z","timestamp":1046476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2003,3]]},"abstract":"<jats:p>Abstract<\/jats:p><jats:p>Over the past decade we have reported excellent outcomes in pediatric living\u2010donor liver transplantation (LDLT) with recipient survival exceeding 90%. Principles established in these patients were extended to LDLT in adults. To compare outcomes in donors and recipients between adult and pediatric LDLT in a single center, we reviewed patient records of 45\u00a0LDLT performed between 1\/98 and 2\/01: 23 adult LDLT (54 \u00b1 6.5 yr) and 22 pediatric LDLT (33.7 \u00b1 53.5\u00a0months). Preoperative liver function was worse in adults (International Normalized Ratio [INR] 1.5 \u00b1 0.4 vs. INR 1.2 \u00b1 0.5; <jats:italic>p<\/jats:italic> = 0.032). 4 adults (17%) met criteria for status 1 or 2A. Only 1 child was transplanted urgently. Analysis included descriptive statistics and Kaplan\u2010Meier estimation. Donor mortality was 0% with 1 re\u2010exploration, 2.4%. Median hospital stay (LOS) was 6.0\u00a0days (range, 4\u201312\u00a0days). Donor morbidity and LOS did not differ by sex, extent of hepatectomy, or adult and pediatric LDLT (<jats:italic>p<\/jats:italic> = 0.49). In contrast, recipient outcomes were worse for adults. Adult 1 year graft survival was 65% (3 retransplants [ReTx], 5 deaths) vs. 91% for children (1 ReTx, 1 death) <jats:italic>p<\/jats:italic> = 0.02. Graft losses in adults were due to sepsis (n = 3), small for size (n = 2), suicide, and hepatic artery thrombosis (HAT), whereas in children graft losses were due to portal thrombosis and total parenteral nutrition (TPN) liver failure. Biliary leaks occurred in 22% of adults and 9% of children. Hepatic vein obstruction occurred in 17% of adults and in none of the children. Median LOS was comparable (adult, 16.5\u00a0days (range, 7\u2013149\u00a0days); child, 17\u00a0days (range, 10\u201356\u00a0days), <jats:italic>p<\/jats:italic> = 0.2). Graft function (total bilirubin (TBili) &lt; 5mg\/dl, INR &lt; 1.2, aspartate aminotransferase (AST) &lt; 100 U\/l) normalizing by day 4\u00a0in children and by day 14\u00a0in adults. Adults fared worse, with an array of problems not seen in children, in particular, hepatic vein obstruction and small\u2010for\u2010size syndrome. Biliary leaks were diagnosed later in adults and were lethal in 3 cases; this was later avoided with biliary drainage in adult recipients. Finally, use of LDLT in decompensated adults led to death in 3 of 4 patients, and should be restricted to elective use.<\/jats:p>","DOI":"10.1007\/s00268-002-6598-8","type":"journal-article","created":{"date-parts":[[2003,2,27]],"date-time":"2003-02-27T16:10:22Z","timestamp":1046362222000},"page":"356-364","source":"Crossref","is-referenced-by-count":48,"title":["Analysis of Failure in Living Donor Liver Transplantation: Differential Outcomes in Children and Adults"],"prefix":"10.1002","volume":"27","author":[{"given":"Michael J.","family":"Goldstein","sequence":"first","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrem","family":"Salame","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Digestive CHU C\u00f4te de Nacre 14000 Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip","family":"Kapur","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Kinkhabwala","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"LaPointe\u2010Rudow","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Harren","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Lobritto","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Russo","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Brown","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guellue","family":"Cataldegirmen","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Renz","sequence":"additional","affiliation":[{"name":"Dumont\u2010UCLA Transplant Center 10833\u00a0Le Conte Avenue 90095 Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean C.","family":"Emond","sequence":"additional","affiliation":[{"name":"Liver Center New York Presbyterian Hospital 622 W. 168th Street, PH14C 10032 New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,3]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-002-6598-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-002-6598-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-002-6598-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T16:17:09Z","timestamp":1704989829000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-002-6598-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,3]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2003,3]]}},"alternative-id":["10.1007\/s00268-002-6598-8"],"URL":"https:\/\/doi.org\/10.1007\/s00268-002-6598-8","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,3]]}}}