{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:07:42Z","timestamp":1789686462516,"version":"4.0.1"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pediatric liver transplantation (PLT) increasingly faces a landscape of limited and suboptimal donor grafts, alongside a rising proportion of complex recipients. Hypothermic-oxygenated perfusion (HOPE) mitigates ischaemia-reperfusion injury and may support graft function in this context.<\/jats:p>\n                  <jats:p>To evaluate feasibility and outcomes of backbench HOPE in complex PLT, compared with a historical cohort of static cold storage (SCS).<\/jats:p>\n                  <jats:p>Prospective cohort of 22 PLT recipients who received a HOPE-perfused liver graft between September 2024 and December 2025, compared with a historical cohort of 32 PLT recipients transplanted after SCS. Variables: donor\/recipient\/graft characteristics, surgical complexity markers, postoperative complications, and survival outcomes.<\/jats:p>\n                  <jats:p>Recipients in both groups had a similar baseline profile, but the HOPE group showed a trend toward greater surgical complexity, with longer hepatectomy times (2.3 vs. 2.1\u2009hours, p\u2009=\u20090.002). Cold ischaemia time was shorter (5.8 [5.1\u20136.7] vs. 8 [6.8\u20139.1] hours; p\u2009&lt;\u20090.001). Median HOPE perfusion was 4.1\u2009hours. Seventy-seven percent of the grafts were reduced\/split on HOPE. Postoperative complications did not differ significantly between groups, and no biliary strictures occurred in the HOPE group compared with five in the SCS group. At 1 year, although patient survival was numerically lower in the HOPE group (77.3% vs. 90.6%, p\u2009=\u20090.200), all deaths occurred with functioning graft; and death-censored graft survival (95.5% vs. 96.8%, p\u2009=\u20090.880) was comparable.<\/jats:p>\n                  <jats:p>In a donor-limited environment with complex recipients, routine backbench HOPE showed graft outcomes and survival comparable to a historical SCS group. These findings suggest a potential role for HOPE beyond graft preservation, supporting surgical synchronization in complex PLT.<\/jats:p>","DOI":"10.1055\/a-2941-3285","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:01:20Z","timestamp":1788994880000},"source":"Crossref","is-referenced-by-count":0,"title":["Hypothermic-Oxygenated Perfusion in Pediatric Liver Transplantation: Beyond Graft Preservation, Facilitating Safer Surgeries in a Donor-Limited Environment"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4795-252X","authenticated-orcid":false,"given":"Irene","family":"Dieguez Hernandez Vaquero","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital, United Kingdom","place":["Birmingham"],"department":["Liver unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca","family":"Sanabria Mateos","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital, United Kingdom","place":["Birmingham"],"department":["Liver unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Sharif","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital, United Kingdom","place":["Birmingham"],"department":["Liver unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Ong","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital, United Kingdom","place":["Birmingham"],"department":["Liver unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Vilca-Melendez","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital, United Kingdom","place":["Birmingham"],"department":["Liver unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Bueno Jimenez","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital, United Kingdom","place":["Birmingham"],"department":["Liver unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"e2022057424","DOI":"10.1542\/peds.2022-057424","article-title":"Prognosis of children undergoing liver transplantation: a 30-year European study","volume":"150","author":"U Baumann","year":"2022","journal-title":"Pediatrics"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/hep.32223","article-title":"European Liver Transplant Registry: donor and transplant surgery aspects of 16,641 liver transplantations in children","volume":"75","author":"J de Ville de Goyet","year":"2022","journal-title":"Hepatology"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"e14825","DOI":"10.1111\/petr.14825","article-title":"Modified by the innovative drugs and strategies-pattern of 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