{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T16:58:27Z","timestamp":1782579507285,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 GM152319"],"award-info":[{"award-number":["T32 GM152319"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005347","name":"American Association for the Study of Liver Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["K23AA031310"],"award-info":[{"award-number":["K23AA031310"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cholestatic liver disease is the leading indication for pediatric liver transplantation (LT). Early detection and optimal care are often limited by socioeconomic barriers including racial disparities. This study examined racial disparities in demographics, waitlists, and post\u2010transplant outcomes among pediatric LT recipients with cholestatic liver disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All pediatric patients (\u2264\u200918\u2009years) who were listed or received LT for cholestatic liver disease (Biliary Atresia, Caroli's, Choledochal cyst, PSC, PFIC, Alagille, and other non\u2010specified cholestatic diseases) between 2010 and 2024 were retrospectively identified using the United Network for Organ Sharing (UNOS) database. The primary outcome of the study was waitlist mortality, graft failure, and post\u2010transplant mortality stratified by race, specifically non\u2010Hispanic whites (NHW), non\u2010Hispanic blacks (NHBs), Hispanics, and others.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      3501 pediatric patients underwent LT for cholestatic liver disease: 1663 (47.5%) were NHW, 795 (22.7%) were Hispanic, 648 (18.5%) were NHB, and 395 (11.3%) were of other races. NHW recipients were more likely to have private insurance (56.7% vs. 18.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and experienced shorter waitlist times than Hispanic patients (175.9 vs. 189.4\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The 1\u2010year survival rate was lower in NHB than in NHW recipients (94.8% vs. 96.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), with no significant difference at 5\u2009years (93.7% vs. 95.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13). Hispanic patients had similar 1\u2010year (95.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26) and 5\u2010year (93.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06) survival rates to NHW. NHB recipients had a significantly increased risk of mortality with a hazard ratio (HR) of 1.53 [95% CI: 1.05\u20132.22]. Predictive modeling using extreme gradient boosting showed a relative likelihood of increased mortality in NHB (3.91%) and Hispanic (3.14%) recipients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Racial disparities significantly affect post\u2010transplant outcomes in pediatric cholestatic liver disease. NHB and Hispanic children face a risk of higher mortality despite similar waitlist outcomes, highlighting the need for targeted interventions to promote equity in pediatric liver transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70261","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T04:41:15Z","timestamp":1769229675000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Racial Disparities in Pediatric Patients With Cholestatic Liver Disease Undergoing Liver Transplant: A\n                    <scp>UNOS<\/scp>\n                    Database Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9488-7364","authenticated-orcid":false,"given":"Ahmad","family":"Anouti","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Texas Southwestern Medical Center  Dallas Texas 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Pediatrics, Pediatric Gastroenterology, Hepatology, and Nutrition University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna Ascher","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Gastroenterology, Hepatology, and Nutrition University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Gastroenterology, Hepatology, and Nutrition University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhu","family":"Pandurangi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Gastroenterology, Hepatology, and Nutrition University of Texas Southwestern Medical Center  Dallas Texas 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