{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:47:34Z","timestamp":1789829254244,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Positive fluid balance (FB) is associated with poor outcomes in critically ill children but has not been studied in pediatric liver transplant (LT) recipients. Our goal is to investigate the relationship between postoperative FB and outcomes in pediatric LT recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study of first\u2010time pediatric LT recipients at a quaternary care children's hospital. Patients were stratified into three groups based on their FB in the first 72\u00a0h postoperatively: &lt;10%, 10\u201320%, and\u2009&gt;\u200920%. Outcomes were pediatric intensive care unit (PICU) and hospital length of stay, ventilator\u2010free days (VFD) at 28\u2009days, day 3 severe acute kidney injury, and postoperative complications. Multivariate analyses were adjusted for age, preoperative admission status, and Pediatric Risk of Mortality (PRISM)\u2010III score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 129 patients with median PRISM\u2010III score of 9 (interquartile range, IQR 7\u201315) and calculated Pediatric End\u2010stage Liver Disease score of 15 (IQR 2\u201323). A total of 37 patients (28.7%) had 10\u201320% FB, and 26 (20.2%) had &gt;20% FB. Greater than 20% FB was associated with an increased likelihood of an additional PICU day (adjusted incident rate ratio [aIRR] 1.62, 95% CI: 1.18\u20132.24), an additional hospital day (aIRR 1.39, 95% CI: 1.10\u20131.77), and lower likelihood of a VFD at 28\u2009days (aIRR 0.85, 95% CI: 0.74\u20130.97). There were no differences between groups in the likelihood of postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In pediatric LT recipients, &gt;20% FB at 72\u00a0h\u00a0postoperatively is associated with increased morbidities, independent of age and severity of illness. Additional studies are needed to explore the impact of fluid management strategies on outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.14499","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T05:10:26Z","timestamp":1679548226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fluid balance in pediatric postoperative liver transplant recipients"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4437-0890","authenticated-orcid":false,"given":"Jessica M.","family":"Winters","sequence":"first","affiliation":[{"name":"Division of Critical Care, Connecticut Children's University of Connecticut School of Medicine  Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Brocks","sequence":"additional","affiliation":[{"name":"Division of Pediatric General Surgery Hospital Sainte\u2010Justine \u2013 Mother\u2010Child University Hospital Center, University of Montr\u00e9al  Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3339-9372","authenticated-orcid":false,"given":"Catherine A.","family":"Chapin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3422-6740","authenticated-orcid":false,"given":"Caroline P.","family":"Lemoine","sequence":"additional","affiliation":[{"name":"Division of Transplant and Advanced Hepatobiliary Surgery, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3076-2244","authenticated-orcid":false,"given":"Riccardo","family":"Superina","sequence":"additional","affiliation":[{"name":"Division of Transplant and Advanced Hepatobiliary Surgery, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5790-1972","authenticated-orcid":false,"given":"Katherine A.","family":"Brandt","sequence":"additional","affiliation":[{"name":"Division of Transplant and Advanced Hepatobiliary Surgery, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7434-6747","authenticated-orcid":false,"given":"L. Nelson","family":"Sanchez\u2010Pinto","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1954-5823","authenticated-orcid":false,"given":"Matthew F.","family":"Barhight","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Ann &amp; Robert H. 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