{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:43:54Z","timestamp":1780494234866,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Cirrhotic children wait\u2010listed for liver transplant are prone to bleeding from gastrointestinal varices. Grade 2\u20103 esophageal varices, red signs, and gastric varices are well\u2010known risk factors. However, the involvement of hemostatic factors remains controversial because of the rebalanced state of coagulation during cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children suffering from decompensated cirrhosis were prospectively included while being on waitlist. Portal hypertension was assessed by ultrasound and endoscopy. Coagulopathy was evaluated through conventional tests, thromboelastometry, and platelet function testing. The included children were followed up until liver transplantation, and all bleeding episodes were recorded. Children with or without bleeding were compared according to clinical, radiological, endoscopic, and biological parameters. In addition, validation of a predictive model for risk of variceal bleeding comprising of grade 2\u20103 esophageal varices, red spots, and fibrinogen level &lt;150\u00a0mg\/dL was applied on this cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 20 enrolled children, 6 had upper gastrointestinal bleeding. Significant differences were observed in fibrinogen level, adenosine diphosphate, and thrombin\u2010dependent platelet aggregation. The model used to compute the upper gastrointestinal bleeding risk had an estimated predictive performance of 81.0%. Platelet aggregation analysis addition improved the estimated predictive performance up to 89.0%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We demonstrated an association between hemostatic factors and the upper gastrointestinal bleeding risk. A low fibrinogen level and platelet aggregation dysfunction may predict the risk of bleeding in children with decompensated cirrhosis. A predictive model is available to assess the upper gastrointestinal bleeding risk but needs further investigations.<\/jats:p><jats:p>Clinicaltrials.gov number: NCT03244332<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13390","type":"journal-article","created":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T02:58:55Z","timestamp":1553050735000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Novel insights into the assessment of risk of upper gastrointestinal bleeding in decompensated cirrhotic children"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4141-6662","authenticated-orcid":false,"given":"Nicolas","family":"Bonnet","sequence":"first","affiliation":[{"name":"Service de gastroent\u00e9rologie et h\u00e9patologie p\u00e9diatrique D\u00e9partement de p\u00e9diatrie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Paul","sequence":"additional","affiliation":[{"name":"DNAlytics Louvain\u2010la\u2010Neuve Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Helleputte","sequence":"additional","affiliation":[{"name":"DNAlytics Louvain\u2010la\u2010Neuve Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Veyckemans","sequence":"additional","affiliation":[{"name":"Service d'anesth\u00e9siologie p\u00e9diatrique D\u00e9partement de m\u00e9decine aigue Centre Hospitalier R\u00e9gional Universitaire de Lille Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Pirotte","sequence":"additional","affiliation":[{"name":"Service d'anesth\u00e9siologie D\u00e9partement de m\u00e9decine aigue Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Pr\u00e9gardien","sequence":"additional","affiliation":[{"name":"Service d'anesth\u00e9siologie D\u00e9partement de m\u00e9decine aigue Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Eeckhoudt","sequence":"additional","affiliation":[{"name":"Service de biologie h\u00e9matologique D\u00e9partement de biologie clinique Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Hermans","sequence":"additional","affiliation":[{"name":"Service d'h\u00e9matologie D\u00e9partement de m\u00e9decine interne Cliniques Universitaires Saint\u2010Luc Unit\u00e9 d'h\u00e9mostase Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Detaille","sequence":"additional","affiliation":[{"name":"Service des soins intensifs p\u00e9diatriques D\u00e9partement de m\u00e9decine aigue Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Clapuyt","sequence":"additional","affiliation":[{"name":"Service de radiologie p\u00e9diatrique D\u00e9partement de radiologie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Menten","sequence":"additional","affiliation":[{"name":"Service de radiologie p\u00e9diatrique D\u00e9partement de radiologie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Dumitriu","sequence":"additional","affiliation":[{"name":"Service de radiologie p\u00e9diatrique D\u00e9partement de radiologie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Reding","sequence":"additional","affiliation":[{"name":"Service de chirurgie p\u00e9diatrique D\u00e9partement de chirurgie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Scheers","sequence":"additional","affiliation":[{"name":"Service de gastroent\u00e9rologie et h\u00e9patologie p\u00e9diatrique D\u00e9partement de p\u00e9diatrie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5573-7817","authenticated-orcid":false,"given":"Sharat","family":"Varma","sequence":"additional","affiliation":[{"name":"Service de gastroent\u00e9rologie et h\u00e9patologie p\u00e9diatrique D\u00e9partement de p\u00e9diatrie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Smets","sequence":"additional","affiliation":[{"name":"Service de gastroent\u00e9rologie et h\u00e9patologie p\u00e9diatrique D\u00e9partement de p\u00e9diatrie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Sokal","sequence":"additional","affiliation":[{"name":"Service de gastroent\u00e9rologie et h\u00e9patologie p\u00e9diatrique D\u00e9partement de p\u00e9diatrie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"St\u00e9phenne","sequence":"additional","affiliation":[{"name":"Service de gastroent\u00e9rologie et h\u00e9patologie p\u00e9diatrique D\u00e9partement de p\u00e9diatrie Cliniques Universitaires Saint\u2010Luc Bruxelles Belgique"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2015.01.140153"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2013.16.1.1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28153"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.07.004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.08021.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.01.042"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000346955"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318282a22c"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v7.i3.392"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i20.6146"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(81)73224-3"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840160607"},{"key":"e_1_2_9_15_1","first-page":"45","article-title":"Upper gastrointestinal tract bleeding management: Belgian guidelines for adults and children","volume":"74","author":"Colle I","year":"2011","journal-title":"Acta Gastroenterol Belg"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03674.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.03.040"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.06.008"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318205993a"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.08.026"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.09.006"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02113249"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(00)90203-3"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2007.11.005"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.06.022"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(03)00181-7"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.35278"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.13390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T15:12:29Z","timestamp":1694358749000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.13390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,19]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/petr.13390"],"URL":"https:\/\/doi.org\/10.1111\/petr.13390","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,19]]},"assertion":[{"value":"2018-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13390"}}