{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:03:11Z","timestamp":1788397391458,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"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":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Socioeconomic status has been associated with inferior outcomes after multiple surgical procedures, but has not been well studied with respect to pediatric liver transplantation. This study evaluated the impact of insurance status (as a proxy for socioeconomic status) on patient and allograft survival in pediatric first\u2010time liver transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our retrospective analysis of the UNOS data base from January 2002 through September 2017 revealed 6997 pediatric patients undergoing first\u2010time isolated liver transplantation. A mixed Cox proportional hazards model adjusted for donor, recipient, and program characteristics determined the RR of insurance status on allograft and patient survival. All results were considered significant at <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05. All statistical results were obtained using R version 3.5.1 and coxme version 2.2\u201010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Medicaid status had a significant negative impact on long\u2010term survival after controlling for multiple covariates. Pediatric patients undergoing first\u2010time isolated liver transplantation with Medicaid insurance had a RR of 1.42 [confidence interval: 1.18\u20101.60] of post\u2010transplant death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pediatric patients undergoing first\u2010time isolated liver transplantation have multiple risk factors that may impact long\u2010term survival. Having Medicaid insurance almost doubles the chances of dying post\u2010liver transplant. This patient population may require more global support post\u2010transplant to improve long\u2010term survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13887","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T13:43:28Z","timestamp":1603892608000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Do funding sources influence long\u2010term patient survival in pediatric liver transplantation?"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8052-7632","authenticated-orcid":false,"given":"Andr\u00e9 A. S.","family":"Dick","sequence":"first","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Washington Seattle WA USA"},{"name":"Section of Pediatric Transplantation Seattle Children's Hospital Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Winstanley","sequence":"additional","affiliation":[{"name":"Department of Social Work Seattle Children's Hospital Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ohara","sequence":"additional","affiliation":[{"name":"Department of Social Work Seattle Children's Hospital Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niviann M.","family":"Blondet","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Pediatrics University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Healey","sequence":"additional","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Washington Seattle WA USA"},{"name":"Section of Pediatric Transplantation Seattle Children's Hospital Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge D.","family":"Reyes","sequence":"additional","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Washington Seattle WA USA"},{"name":"Section of Pediatric Transplantation Seattle Children's Hospital Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15276"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9344-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.6.816"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.24.2.459"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.11.1224"},{"key":"e_1_2_9_7_1","unstructured":"BlasE Sivasankara KurupA.World Health Organization. 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