{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:53:40Z","timestamp":1791456820322,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Combined liver\u2010kidney transplantation is the standard treatment for pediatric primary hyperoxaluria Type 1 with advanced kidney disease, but sequential liver\u2010kidney transplantation is increasingly used where living\u2010donor transplantation predominates. Direct comparisons between these strategies remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 19 pediatric patients with chronic kidney disease Stage 4 or higher who completed combined (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910) or sequential (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099) liver\u2010kidney transplantation for primary hyperoxaluria Type 1 across four countries. The comparative analysis was restricted to patients who received both organs; patients who underwent liver transplantation without subsequent kidney transplantation were excluded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients who completed sequential transplantation had earlier onset of primary hyperoxaluria Type 1\u2010related symptoms (3.0 vs. 12.0\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and lower estimated glomerular filtration rate at liver transplantation (16.5 vs. 36.5\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043) than those who completed combined transplantation. Among recipients who completed both procedures, major perioperative complications and patient survival did not differ significantly; no perioperative deaths occurred after the liver transplantation stage among patients who subsequently completed sequential transplantation. Death\u2010censored kidney graft survival was higher in the completed\u2010sequential group (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Among patients who completed sequential transplantation, an interval exceeding 6\u2009months between liver and kidney transplantation showed a descriptive trend toward better preserved kidney function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among pediatric patients with primary hyperoxaluria Type 1 who completed both liver and kidney transplantation, sequential transplantation was associated with favorable observed kidney graft outcomes. These findings describe outcomes among recipients who completed both procedures and should not be interpreted as outcomes of an initially intended sequential strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70484","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:21:52Z","timestamp":1791454912000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sequential Versus Combined Liver\u2010Kidney Transplantation in Pediatric Primary Hyperoxaluria Type 1: A Multi\u2010Center Comparative Cohort Analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-4790","authenticated-orcid":false,"given":"Ryuji","family":"Komine","sequence":"first","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-0058","authenticated-orcid":false,"given":"Jagadeesh Menon","family":"VR","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hepatology and Nutrition Dr Rela Institute &amp; Medical Centre, Bharath Institute of Higher Education and Research  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Hwa","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreas Surgery Seoul National University Hospital  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6412-1926","authenticated-orcid":false,"given":"Kang\u2010Wong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreas Surgery Seoul National University Hospital  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5792-5045","authenticated-orcid":false,"given":"Toru","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreas Surgery Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5539-9280","authenticated-orcid":false,"given":"Yuji","family":"Soejima","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, Hepato\u2010Biliary\u2010Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery Shinshu University School of Medicine  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1651-0430","authenticated-orcid":false,"given":"Mureo","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the iLDLT Vanguard Multi\u2010Center Study Project","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"issue":"12","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1002\/lt.24009","article-title":"Long\u2010Term Results of Combined Liver\u2010Kidney Transplantation for Primary Hyperoxaluria Type 1: The French Experience","volume":"20","author":"Compagnon P.","year":"2014","journal-title":"Liver Transplantation"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/0014-5793(86)80563-4","article-title":"Peroxisomal Alanine:Glyoxylate Aminotransferase Deficiency in Primary Hyperoxaluria Type I","volume":"201","author":"Danpure C. J.","year":"1986","journal-title":"FEBS Letters"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1159\/000086359","article-title":"A 20\u2010Year Experience of Combined Liver\/Kidney Transplantation for Primary Hyperoxaluria (PH1): The European PH1 Transplant Registry Experience 1984\u20132004","volume":"25","author":"Jamieson N. V.","year":"2005","journal-title":"American Journal of Nephrology"},{"issue":"5","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1093\/ndt\/gfs078","article-title":"Primary Hyperoxaluria Type 1: Indications for Screening and Guidance for Diagnosis and Treatment","volume":"27","author":"Cochat P.","year":"2012","journal-title":"Nephrology, Dialysis, Transplantation"},{"issue":"11","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1111\/j.1600-6143.2010.03271.x","article-title":"Transplantation Outcomes in Primary Hyperoxaluria","volume":"10","author":"Bergstralh E. J.","year":"2010","journal-title":"American Journal of Transplantation"},{"issue":"3","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","DOI":"10.1681\/ASN.2008030287","article-title":"New Equations to Estimate GFR in Children With CKD","volume":"20","author":"Schwartz G. J.","year":"2009","journal-title":"Journal of the American Society of Nephrology"},{"issue":"5","key":"e_1_2_11_8_1","first-page":"518","article-title":"Proposed Classification of Complications of Surgery With Examples of Utility in Cholecystectomy","volume":"111","author":"Clavien P. A.","year":"1992","journal-title":"Surgery"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3389\/fped.2023.1157215","article-title":"Long\u2010Term Outcome After Combined or Sequential Liver and Kidney Transplantation in Children With Infantile and Juvenile Primary Hyperoxaluria Type 1","volume":"11","author":"Loos S.","year":"2023","journal-title":"Frontiers in Pediatrics"},{"issue":"1","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s12876-020-01349-1","article-title":"Outcomes of Liver\u2010Kidney Transplantation in Patients With Primary Hyperoxaluria: An Analysis of the Scientific Registry of Transplant Recipients Database","volume":"20","author":"Xiang J.","year":"2020","journal-title":"BMC Gastroenterology"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1111\/petr.14666","article-title":"Combined Liver\u2010Kidney Transplantation in Pediatric Patients","volume":"28","author":"Yi N. J.","year":"2024","journal-title":"Pediatric Transplantation"},{"issue":"10","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1097\/00007890-200211270-00008","article-title":"Prolongation of Long\u2010Term Kidney Graft Survival by a Simultaneous Liver Transplant: The Liver Does It, and the Heart Does It Too","volume":"74","author":"Opelz G.","year":"2002","journal-title":"Transplantation"},{"issue":"10","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1097\/01.tp.0000241104.58576.e6","article-title":"Comparison of Renal Allograft Outcomes in Combined Liver\u2010Kidney Transplantation Versus Subsequent Kidney Transplantation in Liver Transplant Recipients: Analysis of UNOS Database","volume":"82","author":"Simpson N.","year":"2006","journal-title":"Transplantation"},{"issue":"5","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1097\/SLA.0b013e31817fc2b8","article-title":"The Combined Organ Effect: Protection Against Rejection?","volume":"248","author":"Rana A.","year":"2008","journal-title":"Annals of Surgery"},{"issue":"12","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1007\/s00467-017-3880-4","article-title":"Combined and Sequential Liver\u2010Kidney Transplantation in Children","volume":"33","author":"Grenda R.","year":"2018","journal-title":"Pediatric Nephrology"},{"issue":"4","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/TP.0b013e3182590d6b","article-title":"Combined Liver\u2010Kidney Transplantation Is Preferable to Liver Transplant Alone for Cirrhotic Patients With Renal Failure","volume":"94","author":"Fong T. L.","year":"2012","journal-title":"Transplantation"},{"issue":"9","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1097\/TP.0b013e3181a27939","article-title":"Transplantation Procedures in Children With Primary Hyperoxaluria Type 1: Outcome and Longitudinal Growth","volume":"87","author":"Brinkert F.","year":"2009","journal-title":"Transplantation"},{"issue":"1","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/ajt.16732","article-title":"Posttransplant Recurrence of Calcium Oxalate Crystals in Patients With Primary Hyperoxaluria: Incidence, Risk Factors, and Effect on Renal Allograft Function","volume":"22","author":"Cornell L. D.","year":"2022","journal-title":"American Journal of Transplantation"},{"issue":"5","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.6002\/ect.2019.0150","article-title":"Liver Transplant for Primary Hyperoxaluria Type 1: Results of Sequential, Combined Liver and Kidney, and Preemptive Liver Transplant","volume":"19","author":"Horoub R.","year":"2021","journal-title":"Experimental and Clinical Transplantation"},{"issue":"8","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/petr.12595","article-title":"Combined Liver and Kidney Transplantation and Kidney After Liver Transplantation in Children: Indication, Postoperative Outcome, and Long\u2010Term Results","volume":"19","author":"B\u00fcscher R.","year":"2015","journal-title":"Pediatric Transplantation"},{"issue":"13","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1056\/NEJMoa2021712","article-title":"Lumasiran, an RNAi Therapeutic for Primary Hyperoxaluria Type 1","volume":"384","author":"Garrelfs S. F.","year":"2021","journal-title":"New England Journal of Medicine"},{"issue":"12","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1016\/j.ekir.2020.09.022","article-title":"Transplantation for Primary Hyperoxaluria Type 1: Designing New Strategies in the Era of Promising Therapeutic Perspectives","volume":"5","author":"Devresse A.","year":"2020","journal-title":"Kidney International Reports"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70484","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:21:56Z","timestamp":1791454916000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/petr.70484"],"URL":"https:\/\/doi.org\/10.1111\/petr.70484","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70484"}}