{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:28:16Z","timestamp":1787502496624,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T00:00:00Z","timestamp":1597017600000},"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":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cryptosporidium enteritis can be devastating in the immunocompromised host. In pediatric liver transplant recipients, infection may be complicated by prolonged carriage of the parasite, rejection, and biliary tree damage and fibrosis. Herein, we report on six patients and their long\u2010term outcomes following cryptosporidiosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed all cases of cryptosporidiosis in a pediatric liver transplant population over a 17\u2010year period at a single center. Six patients with infection were identified, and their outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Infection was associated with significant diarrhea and dehydration in all cases, and led to hospitalization in one\u2010half of patients. Four of the six patients developed biopsy\u2010proven rejection following infection, with three of those patients developing rejection that was recalcitrant to intravenous steroid treatment. Additionally, three patients developed biliary tree abnormalities with similarity to sclerosing cholangitis. In one patient, those biliary changes led to repeated need for biliary drain placement and advancing fibrotic liver allograft changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cryptosporidiosis in pediatric liver transplant recipients may lead to significant complications, including recalcitrant episodes of rejection and detrimental biliary tree changes. We advocate for increased awareness of this cause of diarrheal disease and the allograft injuries that may accompany infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.13807","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T18:49:34Z","timestamp":1597085374000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Complications of Cryptosporidium infection after pediatric liver transplantation: Diarrhea, rejection, and biliary disease"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2576-4694","authenticated-orcid":false,"given":"Ryan T.","family":"Fischer","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Christopher","family":"Day","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Wasserkrug","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Faseler","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kats","sequence":"additional","affiliation":[{"name":"Division of Pathology Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Children's 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