{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:40:54Z","timestamp":1762940454738,"version":"3.45.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"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>The primary goal of hepatic artery reconstruction is to restore blood flow to the liver graft and its biliary system. Surgical approaches vary in the number of arterial anastomoses, magnification techniques, and anticoagulation strategies. This study analyzes the anatomical approaches used for arterial reconstruction, the incidence of HAT, and associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A retrospective study of 489 primary pediatric LDLT performed between January 2017 and July 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence rates of HAT, early portal vein thrombosis (EPVT), late\u2010PVT, biliary leak (BL), and biliary stricture (BS) were 1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), 1.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), 4.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921), 15% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200973), and 11.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200958), respectively. Double HA anastomosis was performed in 29.4% (119\/405) of cases, with LHA\u2010LHA\u2009+\u2009MHA\u2010RHA being the most frequent combination. HAT occurred in four patients (1.4%) with single HA anastomosis and one patient (0.8%) in the double HA group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.00). The rates of BS and BL in the single HA group were 14.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951) and 12.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200942), respectively, compared to 16% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921) and 10.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914) in the double HA group (BS:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.72, BL:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.66). Increasing age, CIT, and secondary abdominal closure were associated with higher HAT risk. The overall survival rate was 94.6%, with a median follow\u2010up of 50.7\u2009months (IQR: 21.1\u201373).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study showed a low HAT rate (1%) with increasing age, CIT, and secondary abdominal closure as risk factors. Double HA anastomosis did not reduce biliary complications. The most common HA graft\u2010recipient combinations in this study were LHA\u2010RHA for single HA reconstruction and LHA\u2010LHA\u2009+\u2009MHA\u2010RHA for double HA reconstruction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70212","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T04:19:55Z","timestamp":1761106795000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Double Versus Single Hepatic Artery Anastomosis in Pediatric Left Liver Grafts: A Reassessment of Outcomes"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-1077","authenticated-orcid":false,"given":"Carolina Magalh\u00e3es","family":"Costa","sequence":"first","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-9533","authenticated-orcid":false,"given":"Eduardo Antunes","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1167-6829","authenticated-orcid":false,"given":"Renata Pereira Sustovich","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel Ruiz","family":"Benavides","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina Moreira","family":"de Oliveira Roda","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Vincenzi","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-440X","authenticated-orcid":false,"given":"Nath\u00e1lia Rangel Porto","family":"Travassos","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7644-3372","authenticated-orcid":false,"given":"Debora Puzzi","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0274-6274","authenticated-orcid":false,"given":"Gilda","family":"Porta","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene Kazue","family":"Miura","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo S\u00e3o Paulo 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