{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:35:16Z","timestamp":1771929316030,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study assesses the impact of cholestatic liver disease, including biliary atresia, on 25\u2010year survival post\u2010transplantation and additional factors influencing long\u2010term outcomes after pediatric liver transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of pediatric liver transplant recipients (1987\u20131998) using de\u2010identified data from the OPTN 2023 Liver Database. After exclusions for multi\u2010organ transplants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009222), prior transplants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092256), and deaths within 1\u2009year (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009526), 2429 patients remained, including 645 with cholestatic disease. Univariate and multivariate analyses identified factors associated with 25\u2010year survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A primary diagnosis of cholestatic disease was associated with improved 25\u2010year survival (OR: 0.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023). UNOS regions 2 (OR: 0.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and 5 were also associated with improved survival (OR: 0.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044). Decreased survival was associated with recipient ages 8\u201312 (OR: 1.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and 12\u201318 (OR: 2.90,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), donor age \u2265\u200919 (OR: 1.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), African\u2010American (OR: 1.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.000) and other minority recipient ethnicities (OR: 2.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), donor bilirubin \u2265\u20092\u2009mg\/dL (OR: 1.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), and UNOS region 10 (OR: 1.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study evaluates 25\u2010year survival in pediatric liver transplant recipients while analyzing the protective influence of a cholestatic disease diagnosis. Older recipient and donor ages, minority recipient ethnicities, elevated donor bilirubin, and specific UNOS regions are associated with decreased 25\u2010year survival. Further research is needed to address outcome inequalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70189","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T05:44:53Z","timestamp":1758865493000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Influencing 25\u2010Year Survival in Pediatric Liver Transplant Recipients"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6492-1392","authenticated-orcid":false,"given":"Garrett","family":"Wortham","sequence":"first","affiliation":[{"name":"Department of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8212-5586","authenticated-orcid":false,"given":"Megan","family":"Crawford","sequence":"additional","affiliation":[{"name":"Department of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8313-608X","authenticated-orcid":false,"given":"John","family":"Miggins","sequence":"additional","affiliation":[{"name":"Department of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Sing","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplant, Michael E DeBakey Department of Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Goss","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplant, Michael E DeBakey Department of Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Rana","sequence":"additional","affiliation":[{"name":"Division 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