{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:03:13Z","timestamp":1790380993585,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>ABO\u2010incompatible (ABO\u2010i) liver transplantation (LT) in children is increasingly used to address organ scarcity, but concerns about immunological, vascular, and biliary complications remain. With evolving desensitization strategies and emerging pediatric data, an updated meta\u2010analysis comparing ABO\u2010i and ABO\u2010compatible (ABO\u2010c) LT is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Scopus were searched from inception to June 2026 to include studies evaluating ABO\u2010i versus ABO\u2010c LT in recipients \u2264\u200918\u2009years of age. Primary outcomes were comparison of 1\u2010, 3\u2010, and 5\u2010year patient and graft survival between the two groups. Secondary outcomes included comparisons of vascular and biliary complications, rejection, cytomegalovirus (CMV) and Epstein\u2013Barr virus (EBV) infections, and post\u2010transplant lymphoproliferative disease (PTLD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen studies were included. Patient survival was comparable between the two groups at 1 year (risk ratio [RR]: 0.97, 95% confidence interval [CI]: 0.94\u20131.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07), 3\u2009years (RR: 0.98, 95% CI: 0.94\u20131.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.22) and 5\u2009years (RR: 0.97, 95% CI: 0.88\u20131.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.50). Likewise, graft survival showed no significant differences. Incidence of vascular and biliary complications, acute rejection, CMV and EBV infection, and PTLD also did not differ significantly between groups. Antibody\u2010mediated rejection (AMR) was significantly higher in ABO\u2010i recipients (RR: 20.04, 95% CI: 3.25\u2013123.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), although this finding was based on only four studies. Overall, heterogeneity was low. Certainty of evidence was rated as very low, primarily due to the observational design of included studies and risk of bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ABO\u2010i LT in pediatric recipients demonstrates survival and complication outcomes comparable to those of ABO\u2010c LT. However, very low certainty of evidence highlights the need for future well\u2010designed prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70430","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T12:56:25Z","timestamp":1787835385000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of\n                    <scp>ABO<\/scp>\n                    \u2010Incompatible Versus\n                    <scp>ABO<\/scp>\n                    \u2010Compatible Liver Transplantation in Pediatric Recipients: An Updated Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-5743","authenticated-orcid":false,"given":"Kalpana","family":"Panda","sequence":"first","affiliation":[{"name":"Division of Pediatric Hepatology, Department of Pediatric Institute of Medical Sciences and SUM Hospital  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6275-7736","authenticated-orcid":false,"given":"Bikrant Bihari","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0800-4068","authenticated-orcid":false,"given":"Rajeev","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-4084","authenticated-orcid":false,"given":"Vikrant","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-8625","authenticated-orcid":false,"given":"Seema","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","first-page":"489","article-title":"Antibody\u2010Mediated Rejection of Human Orthotopic Liver Allografts. 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