{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:05:41Z","timestamp":1790381141027,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) is a significant complication in pediatric liver transplant (LT) patients. This is often exacerbated by liver dysfunction, fluid overload, and metabolic disturbances. Intraoperative continuous kidney replacement therapy (IO\u2010CKRT) is an emerging strategy to manage these complex patients, aiming to stabilize fluid, electrolyte, and acid\u2013base imbalances. Epoprostenol is utilized as an anticoagulant during CKRT to maintain circuit patency, particularly in patients at high risk of bleeding by inhibiting platelet aggregation. However, the use of IO\u2010CKRT with epoprostenol specifically in pediatric LT recipients is poorly documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present a case of a 12\u2009year\u2010old girl with biliary atresia and cirrhosis who underwent urgent LT from a deceased donor. She developed hemorrhagic shock and multi\u2010organ failure, necessitating pre\u2010transplant plasmapheresis and subsequent CKRT with epoprostenol. IO\u2010CKRT was maintained during the 12\u2009h LT to manage acid\u2013base balance, electrolyte levels, and volume status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Despite epoprostenol anticoagulation for hemofiltration, no abnormal bleeding occurred in the gastrointestinal or surgical areas during transplantation. Post\u2010transplantation, the patient's inotropic support requirements decreased within 24\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IO\u2010CKRT effectively achieves fluid and metabolic balance during LT in pediatric patients with AKI, fluid overload, and metabolic issues. Epoprostenol proves to be a safe and effective regional anticoagulation option for CKRT in bleeding patients undergoing LT, preventing site bleeding without systemic complications. This case highlights a unique and important application that warrants further investigation into its broader effectiveness and potential complications in this vulnerable patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70469","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:39:09Z","timestamp":1790055549000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Continuous Kidney Replacement Therapy With Regional Epoprostenol Anticoagulation During Liver Transplantation in a Child With Severe Gastrointestinal Bleeding"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3696-7382","authenticated-orcid":false,"given":"Eda","family":"Eyduran","sequence":"first","affiliation":[{"name":"Department of Pediatric Critical Care Ankara University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8865-2914","authenticated-orcid":false,"given":"Duygu","family":"\u0130yi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ankara University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7699-5652","authenticated-orcid":false,"given":"Ay\u015fen Durak","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Critical Care Ankara University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7329-6109","authenticated-orcid":false,"given":"Ulkar","family":"Huseyinova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ankara University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3431-7906","authenticated-orcid":false,"given":"Merve","family":"Havan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Critical Care Ankara University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9458-2803","authenticated-orcid":false,"given":"Tan\u0131l","family":"Kendirli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Critical Care Ankara University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02859289"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103046.2010.01457.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e328052c4cc"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618817061"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003371"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25773"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467\u2010023\u201006272\u20107"},{"issue":"3","key":"e_1_2_8_9_1","first-page":"238","article-title":"An Evaluation of Intraoperative Renal Support During Liver Transplantation: A Matched Cohort Study","volume":"32","author":"Parmar A.","year":"2011","journal-title":"Research Articles"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452754"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003547"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i42.5552"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.07.011"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2015.06.006"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1586\/17474124.2013.837264"},{"key":"e_1_2_8_16_1","unstructured":"W. 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