{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T05:16:16Z","timestamp":1755926176200,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,16]],"date-time":"2018-02-16T00:00:00Z","timestamp":1518739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2018,3]]},"abstract":"Abstract<\/jats:title>Collateral circulation secondary to liver cirrhosis may cause the development of large PSSs that may steal flow from the main portal circulation. It is important to identify these shunts prior to, or during the transplant surgery because they might cause an insufficient portal flow to the implanted graft. There are few reports of \u201csteal flow syndrome\u201d cases in pediatrics, even in biliary atresia patients that may have portal hypoplasia as an associated malformation. We present a 12\u2010month\u2010old female who received an uneventful LDLT<\/jats:styled-content> from her mother, and the GRWR<\/jats:styled-content> was 4.8. During the early post\u2010operative period, she became hemodynamically unstable, developed ascites, and altered LFT. The post\u2010operative ultrasound identified reversed portal flow, finding a non\u2010anatomical PSS. A 3D CT<\/jats:styled-content> scan confirmed the presence of a mesocaval shunt through the territory of the right gonadal vein, draining into the right iliac vein, with no portal inflow into the liver. The patient was re\u2010operated, and the shunt was ligated. An intraoperative Doppler ultrasound showed adequate portal inflow after the procedure; the patient evolved satisfactorily and was discharged home on day number 49. The aim was to report a case of post\u2010operative steal syndrome in a pediatric recipient due to a mesocaval shunt not diagnosed during the pretransplant evaluation.<\/jats:p>","DOI":"10.1111\/petr.13111","type":"journal-article","created":{"date-parts":[[2018,2,17]],"date-time":"2018-02-17T04:06:44Z","timestamp":1518840404000},"source":"Crossref","is-referenced-by-count":1,"title":["Unusual spontaneous porto\u2010systemic shunt: The importance of diagnosing non\u2010anatomical porto\u2010systemic shunts to improve portal flow in pediatric living\u2013related liver transplantation. Case report"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3850-6130","authenticated-orcid":false,"given":"Juan S.","family":"Rubio","sequence":"first","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Rumbo","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"},{"name":"Pediatric Hepatology and Pediatric Liver Transplant Unit Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo A.","family":"Farinelli","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00e1s","family":"Aguirre","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego A.","family":"Ramisch","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"Paladini","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"},{"name":"Radiology Department Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"D\u00b4Angelo","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"},{"name":"Radiology Department Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Barros Schelotto","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel E.","family":"Gondolesi","sequence":"additional","affiliation":[{"name":"Hepatology HPB Surgery and Liver Transplant Unit Hospital Universitario Fundaci\u00f3n Favaloro Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,16]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_7_2_1","DOI":"10.1007\/s00270-009-9739-8"},{"doi-asserted-by":"publisher","key":"e_1_2_7_3_1","DOI":"10.1111\/j.1399-0012.2010.01217.x"},{"doi-asserted-by":"publisher","key":"e_1_2_7_4_1","DOI":"10.1016\/j.transproceed.2012.05.090"},{"doi-asserted-by":"publisher","key":"e_1_2_7_5_1","DOI":"10.1111\/tri.12086"},{"doi-asserted-by":"publisher","key":"e_1_2_7_6_1","DOI":"10.6002\/ect.2011.0201"},{"doi-asserted-by":"publisher","key":"e_1_2_7_7_1","DOI":"10.1002\/lt.21377"},{"key":"e_1_2_7_8_1","first-page":"1120","article-title":"Spontaneous portosystemic shunts in cirrhotics: implications for orthotopic liver transplantation","volume":"25","author":"Cherqui D","year":"1993","journal-title":"Transplant Proc"},{"key":"e_1_2_7_9_1","first-page":"1946","article-title":"Effect of surgical and spontaneous 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