{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T19:08:36Z","timestamp":1778699316751,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"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":["Hepatology Research"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Esophagogastric variceal (EGV) bleeding is a serious complication of pediatric\u2010onset liver disease; however, evidence regarding endoscopic management and long\u2010term outcomes remains limited. This study aimed to evaluate clinical outcomes following endoscopic therapy for pediatric EGV and to clarify challenges related to adherence and transitional care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients with pediatric\u2010onset liver disease who underwent endoscopic treatment for EGV between 2012 and 2024. Patients were categorized into a childhood group (\u2264 15\u00a0years) and a young adult group (&gt;\u00a015\u00a0years). Clinical characteristics, treatment outcomes, retreatment, survival, and adherence during the transition to adult care were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Emergency endoscopy for hematemesis was common in the childhood group. Despite frequent recurrence, endoscopic therapy was effective and no rebleeding or deaths occurred. In contrast, young adults showed significantly poorer survival (1\u2010year 84.6%; 2\u2010year 69.2%; and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.045), primarily due to hepatic decompensation. Nearly half self\u2010discontinued follow\u2010up during the transition period, and nonadherence was associated with higher Child\u2013Pugh and MELD scores and markedly reduced survival (5\u2010year 33.3% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.038). Some young adults later developed alcohol\u2010related liver disease, with significantly worse outcomes than the childhood group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.023).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic therapy is effective and safe for pediatric EGV, although recurrence is common. In young adults, long\u2010term outcomes are determined more by adherence and successful transitional care than by variceal severity. Structured transitional programs are essential for preventing loss to follow\u2010up and improving survival in pediatric\u2010onset portal hypertension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70117","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T11:31:42Z","timestamp":1767871902000},"page":"735-743","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Outcomes and Transitional Care Following Endoscopic Variceal Treatment in Pediatric Portal Hypertension"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-2760","authenticated-orcid":false,"given":"Akira","family":"Uchiyama","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Juntendo University School of Medicine  Tokyo 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