{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T05:29:59Z","timestamp":1764653399505,"version":"3.46.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder that can cause vascular malformations in multiple organs, including the liver. Although liver involvement typically remains asymptomatic until adulthood, severe cases can progress to high\u2010output cardiac failure (HOCF). Although liver transplantation (LT) is a well\u2010established curative option for adult patients with HHT, pediatric data are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present a case of a 3\u2010month\u2010old boy with HOCF due to hepatic arteriovenous malformations (AVMs) caused by HHT. Prenatal imaging revealed hepatic AVMs and a ventricular septal defect (VSD), necessitating a semi\u2010emergent cesarean delivery due to rapid cardiac enlargement. To reduce blood flow to the AVMs, hepatic artery ligation and transcatheter embolization were performed within the first week of life. At 3\u00a0weeks, progressive pulmonary blood flow led to pulmonary artery banding to address the tricuspid regurgitant gradient exceeding 50\u00a0mmHg. Given the life\u2010threatening nature of the high\u2010output state due to the hepatic AVMs, LT was deemed essential and was strategically performed prior to VSD closure. The patient successfully transitioned off continuous catecholamine support by postoperative Day 3 and has remained stable for 2\u00a0years without recurrence of heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Conclusion<\/jats:title>\n                    <jats:p>This is the first report demonstrating the feasibility and effectiveness of LT in pediatric HHT patients with severe cardiac complications, including right\u2010to\u2010left shunting. The case highlights the natural history of HHT in childhood and provides guidance on optimal treatment strategies, particularly a decision to perform LT first while leaving right\u2010to\u2010left shunting and operative procedures to prevent perioperative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70020","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T12:56:13Z","timestamp":1756299373000},"page":"1683-1690","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Living Donor Liver Transplantation for Symptomatic Liver Involvement in Infant With Hereditary Hemorrhagic Telangiectasia"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-4790","authenticated-orcid":false,"given":"Ryuji","family":"Komine","sequence":"first","affiliation":[{"name":"Organ Transplantation Center National Center for Child Health and 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