{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T15:02:03Z","timestamp":1780153323336,"version":"3.54.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":54,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report on an infant girl with biliary atresia, who, at the age of 6 months, received a living-related liver transplantation (LRLT), (segments II\/III) from her 37-year-old healthy mother. Five months after LRLT, the child developed skin lesions on sunlight exposed skin areas. Based on plasma fluorescence scanning, biochemical findings and DNA testing variegate porphyria (VP) was diagnosed in the girl. In this remarkable case hepatic heme synthesis was induced in the transplanted liver through medication (metamizole), stress and infection (cholangitis), unmasking previously undiscovered partial enzyme deficiency of PPOX. LRLT with subsequent manifestation of heterozygous VP in very early childhood has not been described hitherto. Our report will increase awareness of \u201crare risks\u201d for \u201crare diseases\u201d in liver transplantation.<\/jats:p>","DOI":"10.1093\/gastro\/goag020","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:45:03Z","timestamp":1770813903000},"source":"Crossref","is-referenced-by-count":0,"title":["Liver graft as a \u2018Trojan horse\u2019: manifestation of variegate porphyria in an 11-month-old girl with biliary atresia after living-related liver transplantation"],"prefix":"10.1093","volume":"14","author":[{"given":"Ulrich","family":"St\u00f6lzel","sequence":"first","affiliation":[{"name":"Division of Internal Medicine II and Porphyria Center , Klinikum Chemnitz, D-09116 Chemnitz,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Knoppke","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Regensburg (KUNO), University Hospital Regensburg , D-93053 Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Stauch","sequence":"additional","affiliation":[{"name":"Deutsches Kompetenz-Zentrum fu\u0308r Porphyriediagnostik und Konsultation, MVZ Labor Volkmann und Kollegen GbR , D-76131 Karlsruhe,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria I von","family":"Eichborn","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Regensburg , D-93053 Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert L","family":"Bonkovsky","sequence":"additional","affiliation":[{"name":"Section on Gastroenterology & Hepatology, Wake Forest University School of Medicine and Advocate Health Wake Forest Baptist Medicine , Winston-Salem, 27157 NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Melter","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Regensburg (KUNO), University Hospital Regensburg , D-93053 Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"2026053010370127300_goag020-B1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/hmg\/5.3.407","article-title":"Mutations in the protoporphyrinogen oxidase gene in patients with variegate porphyria","volume":"5","author":"Deybach","year":"1996","journal-title":"Hum Mol Genet"},{"key":"2026053010370127300_goag020-B2","doi-asserted-by":"crossref","first-page":"e16012","DOI":"10.1111\/liv.16012","article-title":"Practical recommendations for biochemical and genetic diagnosis of the porphyrias","volume":"45","author":"Aarsand","year":"2025","journal-title":"Liver 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porphyrias","volume":"157","author":"St\u00f6lzel","year":"2019","journal-title":"Gastroenterology"},{"key":"2026053010370127300_goag020-B6","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/S0140-6736(84)92298-0","article-title":"Homozygous variegate porphyria","volume":"1","author":"Kordac","year":"1984","journal-title":"Lancet"},{"key":"2026053010370127300_goag020-B7","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/ced.12071","article-title":"Homozygous variegate porphyria presenting with developmental and language delay in childhood","volume":"38","author":"Pinder","year":"2013","journal-title":"Clin Exp Dermatol"},{"key":"2026053010370127300_goag020-B8","first-page":"001688","article-title":"Variegate porphyria triggered by acute hepatitis A infection","volume":"7","author":"Micallef","year":"2020","journal-title":"Eur J Case Rep Intern 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