{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:44:10Z","timestamp":1792075450750,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"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":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effect of post\u2010operative ganciclovir therapy on transplant\u2010free liver survival in children with biliary atresia (BA) complicated by cytomegalovirus (CMV) infection, and to propose an intervention mechanism hypothesis based on the \u2018CMV\u2013hepatic stellate cell\u2013fibrosis\u2013long\u2010term prognosis\u2019 pathogenic axis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included children diagnosed with BA complicated by CMV infection at a tertiary children's hospital between January 2017 and October 2023. Patients were divided into a treatment group and a non\u2010treatment group based on whether ganciclovir was administered for \u2265\u20091\u2009week within 3\u2009months after Kasai portoenterostomy (KPE). All patients had follow\u2010up of at least 2\u2009years by 1 October 2025. Baseline characteristics and clinical outcomes (transplant\u2010free liver survival time and 3\u2010month post\u2010operative jaundice clearance rate) were compared between groups. Kaplan\u2013Meier analysis was used to generate survival curves, and differences were assessed using the Log\u2010Rank test. Evidence from basic and clinical research was integrated to construct a mechanistic hypothesis diagram for CMV\u2010driven hepatic fibrosis and antiviral intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 17 children with BA were included, with 6 in the treatment group and 11 in the non\u2010treatment group. Baseline characteristics indicated no significant differences between the two groups in terms of sex, hepatic fibrosis stage, age at surgery, preoperative DBIL and other clinical indicators, demonstrating balanced comparability (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Comparison of clinical outcomes and Kaplan\u2013Meier survival curves showed that transplant\u2010free liver survival time was significantly longer in the treatment group than in the non\u2010treatment group: 1518 (217, 2825) versus 190 (83, 265) days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035; the survival curve showed an improving trend (Log\u2010Rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.087). The 3\u2010month post\u2010operative jaundice clearance rate did not differ significantly between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). The mechanistic hypothesis diagram suggested that CMV may activate hepatic stellate cells via multiple pathways, including CCL19\/CCR7 and TGF\u2010\u03b2, accelerating fibrosis progression, while ganciclovir may block this process.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ganciclovir antiviral therapy may be associated with improved transplant\u2010free liver survival in CMV\u2010positive children with BA, exerting a specific effect on long\u2010term fibrosis progression rather than short\u2010term bile drainage. This clinical observation aligns with the \u2018CMV\u2013fibrosis\u2013long\u2010term prognosis\u2019 pathogenic axis hypothesis and provides preliminary evidence for clinical antiviral treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70496","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T06:22:26Z","timestamp":1786083746000},"page":"1907-1912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ganciclovir Improves Transplant\u2010Free Liver Survival in Children With Biliary Atresia and Concurrent Cytomegaloviral Infection: A Pilot Study"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7694-0347","authenticated-orcid":false,"given":"Huang","family":"Teng","sequence":"first","affiliation":[{"name":"Medical School of Nanchang University  Nanchang China"},{"name":"Neonatal Surgery Jiangxi Provincial Children's Hospital  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Qian","sequence":"additional","affiliation":[{"name":"Medical School of Nanchang University  Nanchang China"},{"name":"Department of Nephrology Jiangxi Provincial Children's Hospital  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Hao","sequence":"additional","affiliation":[{"name":"Neonatal Surgery Jiangxi Provincial Children's Hospital  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huang","family":"Jinshi","sequence":"additional","affiliation":[{"name":"Neonatal Surgery Jiangxi Provincial Children's Hospital  Nanchang China"},{"name":"National Children's Medical Center, Neonatal Surgery, Beijing Children's Hospital Affiliated to Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(73)92970\u2010x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.710450"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.26287"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.29842"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383\u2010021\u201004933\u2010y"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383\u2010023\u201005394\u20101"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101754.2004.00430.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1005\u20106483.2021.06.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn421158\u201020200518\u201000350"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2026.163190"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2015.03.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.12.014"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.08.763"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003846"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800374"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/mi\/9889239"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.751204"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP281061"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010020\u201000372\u20107"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70496","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70496","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:45:03Z","timestamp":1792071903000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jpc.70496"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70496","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"assertion":[{"value":"2026-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}