{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T19:01:01Z","timestamp":1775674861843,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017540","name":"Division of Intramural Research","doi-asserted-by":"publisher","award":["K23HL146936"],"award-info":[{"award-number":["K23HL146936"]}],"id":[{"id":"10.13039\/100017540","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017540","name":"Division of Intramural Research","doi-asserted-by":"publisher","award":["K23HL150244"],"award-info":[{"award-number":["K23HL150244"]}],"id":[{"id":"10.13039\/100017540","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the incidence and risk factors for postoperative infections (POI) after pediatric liver transplantation (LT) while in the pediatric intensive care unit (PICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a multicenter, retrospective cohort study of isolated pediatric LT recipients from 12 LT centers in the United States over 2\u2009years. Pre\u2010 and postoperative variables were examined to determine POI risk factors during the PICU admission. Antimicrobial prophylaxis utilization was assessed. Comparative statistics were performed using chi\u2010squared and Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests. Multivariable logistic regression modeling evaluated POI risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      76\/327 (23%) patients developed POI (47% bacterial, 3% viral, 4% fungal, 22% polymicrobial, and 21% clinically adjudicated, culture negative). Abdominal\/surgical site and bloodstream infections were most common at 29% and 26%, respectively. Independent predictors of POI included age under 1 (OR\u2009=\u20092.37 [95% CI 1.36\u20134.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), open fascia (OR\u2009=\u20093.15 [95% CI 1.77\u20135.61],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and hospitalization pre\u2010transplant (OR\u2009=\u20092.09 [95% CI 1.20\u20133.64],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Patients with POI had longer hospitalizations (23.0\u2009days [17.0\u201334.0] vs. 13.0\u2009days [9.0\u201320.0],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), higher graft loss rates (9% vs. 0.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and greater mortality (5% vs. 0.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Significant variability in antimicrobial regimens existed amongst transplant centers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>One in five patients developed POI while in the PICU. Predictors of POI included younger age, open fascia, and hospitalization pre\u2010transplantation. POIs were associated with significant morbidity, including prolonged length of stay, graft loss, and mortality. Future prospective studies are needed to optimize antimicrobial regimens to prevent POI and improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70158","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T09:17:41Z","timestamp":1754903861000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Postoperative Infections and Antimicrobial Prophylaxis in the Pediatric Intensive Care Unit After Liver Transplantation in Children"],"prefix":"10.1111","volume":"29","author":[{"given":"Elise","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Pediatrics Columbia University Irving Medical Center  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-5681","authenticated-orcid":false,"given":"Alicia M.","family":"Alcamo","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle K.","family":"Maue","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati USA"},{"name":"Department of Pediatrics Indiana University School of Medicine  Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Beltramo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care Children's Hospital of Los Angeles  Los Angeles USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asumthia","family":"Jeyapalan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Miami Miller School of Medicine  Miami USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Nares","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Miami Miller School of Medicine  Miami USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Monde","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Georgetown University Hospital  Washington D.C. USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Ridall","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado School of Medicine  Aurora USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Duke University  Durham USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney M.","family":"Rowan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Indiana University School of Medicine  Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4300-2594","authenticated-orcid":false,"given":"Richard S.","family":"Mangus","sequence":"additional","affiliation":[{"name":"Department of Surgery Indiana University School of Medicine  Bloomington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubhi","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Montefiore Medical Center, Icahn School of Medicine at Mount Sinai  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew S.","family":"Zinter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Francisco  San Francisco USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8204-3981","authenticated-orcid":false,"given":"Joseph","family":"Resch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Minnesota  Minneapolis USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3879-6660","authenticated-orcid":false,"given":"Kristina","family":"Betters","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Vanderbilt University  Nashville USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul K.","family":"Sue","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia University Irving Medical Center  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6128-0155","authenticated-orcid":false,"given":"Mercedes","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia University Irving Medical Center  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.02.006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.02068.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318175d7d2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13208"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004047"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16743"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp120568"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12020292"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003101"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.liver.2023.100185"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.01.014"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000811"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/725748"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2004.00128.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002662"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14631"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2013.9999"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae095"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13538"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12925"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13623"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pix041"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.107003"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12663"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2009.01136.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i11.1159"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13001"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.500050105"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000023169"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:35:11Z","timestamp":1764678911000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/petr.70158"],"URL":"https:\/\/doi.org\/10.1111\/petr.70158","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]},"assertion":[{"value":"2025-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70158"}}