{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:02:40Z","timestamp":1788397360999,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,29]],"date-time":"2017-05-29T00:00:00Z","timestamp":1496016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30KD034989"],"award-info":[{"award-number":["P30KD034989"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000142"],"award-info":[{"award-number":["UL1 TR000142"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The long\u2010term course and outcome of <jats:styled-content style=\"fixed-case\">DAIH<\/jats:styled-content> is unknown. A retrospective multicenter study assessing associations and long\u2010term consequences of <jats:styled-content style=\"fixed-case\">DAIH<\/jats:styled-content> developing in a transplanted allograft is presented. Children with <jats:styled-content style=\"fixed-case\">DAIH<\/jats:styled-content> were followed from diagnosis until death, re\u2010<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>, or transfer of care and for a minimum of 1\u00a0year. A total of 31 patients of 1833 (1.7%) <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> were identified; 29 followed for a median of 7.1\u00a0years (range, 1.6\u201015); 52% had no rejection preceding diagnosis of <jats:styled-content style=\"fixed-case\">DAIH<\/jats:styled-content>. Transaminases fell following treatment with steroids and antimetabolites (<jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> 108 vs 39 U\/L (<jats:italic>P<\/jats:italic>=.002); <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content> 112 vs 52 U\/L (<jats:italic>P<\/jats:italic>=.003); <jats:styled-content style=\"fixed-case\">GGT<\/jats:styled-content> 72 vs 36 U\/L (<jats:italic>P<\/jats:italic>=.03), but this was not universally sustained. Transaminases &gt;2X <jats:styled-content style=\"fixed-case\">ULN<\/jats:styled-content> observed in 38% of patients at last follow\u2010up; commonly <jats:styled-content style=\"fixed-case\">GGT<\/jats:styled-content>, attributed to bile duct injury and ductopenia. Portal hypertension (<jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content>) was seen in four patients and associated with severe fibrosis and cirrhosis. Re\u2010<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> occurred in two patients for chronic rejection (<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>) and uncontrolled <jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content> with gastrointestinal bleeding, respectively. No deaths from <jats:styled-content style=\"fixed-case\">DAIH<\/jats:styled-content> were reported. <jats:styled-content style=\"fixed-case\">DAIH<\/jats:styled-content> is an uncommon complication following pediatric <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> requiring prolonged and augmented immunosuppression. It is associated with continued allograft dysfunction and may lead to bile duct injury, <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content> necessitating re\u2010<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/petr.12945","type":"journal-article","created":{"date-parts":[[2017,5,29]],"date-time":"2017-05-29T10:48:54Z","timestamp":1496054934000},"source":"Crossref","is-referenced-by-count":23,"title":["Long\u2010term outcomes of de novo autoimmune hepatitis in pediatric liver transplant recipients"],"prefix":"10.1111","volume":"21","author":[{"given":"Udeme D.","family":"Ekong","sequence":"first","affiliation":[{"name":"Department of Pediatrics Yale University School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"McKiernan","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh University of Pittsburgh Medical Center  Pittsburgh PA USA"},{"name":"The Liver Unit Birmingham Children's Hospital and University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia University  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Lobritto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia University  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Kelly","sequence":"additional","affiliation":[{"name":"The Liver Unit Birmingham Children's Hospital and University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky L.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of 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