{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:45:00Z","timestamp":1791780300062,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"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>Biliary strictures are among the most frequent complications following pediatric liver transplantation and can compromise graft function if not promptly managed. Endoscopic retrograde cholangiopancreatography (ERCP) is increasingly recognized as a safe, minimally invasive first\u2010line therapy, though pediatric data remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed children under 18\u2009years who developed post\u2010transplant biliary strictures between 2017 and 2025 at two tertiary centers in Shiraz, Iran. Demographic, clinical, and procedural data were analyzed. Procedural success was defined as restoration of bile flow, and overall patient outcomes were evaluated across all ERCP sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 362 pediatric liver transplant recipients, 31 (8.5%) developed biliary strictures, and 27 met inclusion criteria (12 males, 15 females). A total of 87 ERCP sessions were performed, with an overall success rate of 70.4%. Six patients (22.2%) required percutaneous transhepatic biliary drainage, and two (7.4%) underwent surgical intervention. Serum ALT and ALP levels significantly decreased after ERCP (ALT: 123 to 46\u2009U\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02; ALP: 767 to 568\u2009U\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028; Wilcoxon signed\u2010rank test), whereas total bilirubin changes were not significant. Complications occurred in 12.6% of procedures, mainly mild post\u2010ERCP pancreatitis (6.9%), all managed conservatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ERCP is a safe and effective initial treatment for post\u2010transplant biliary strictures in children. Complications are generally minor and manageable, supporting its role as a minimally invasive therapeutic option in pediatric liver transplant centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70486","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:49:57Z","timestamp":1791776997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and Safety of Endoscopic Retrograde Cholangiopancreatography for Post\u2010Transplant Biliary Strictures in Children: Experience From Two Centers in Southern Iran"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3760-7717","authenticated-orcid":false,"given":"Iraj","family":"Shahramian","sequence":"first","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-0413","authenticated-orcid":false,"given":"Mohammad Hadi","family":"Imanieh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0435-7643","authenticated-orcid":false,"given":"Mahmood","family":"Haghighat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-0110","authenticated-orcid":false,"given":"Seyed Mohsen","family":"Dehghani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7993-2681","authenticated-orcid":false,"given":"Naser","family":"Honar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1876-5266","authenticated-orcid":false,"given":"Maryam","family":"Ataollahi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0853-9938","authenticated-orcid":false,"given":"Seyed Ali","family":"Malekhosseini","sequence":"additional","affiliation":[{"name":"Abu Ali Sina Hospital for Medicine and Organ Transplantation Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-5754","authenticated-orcid":false,"given":"Gholamreza","family":"Sivandzadeh","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Research Center, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0791-0133","authenticated-orcid":false,"given":"Fardad","family":"Ejtehadi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Research Center, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2608-8018","authenticated-orcid":false,"given":"Ramin","family":"Niknam","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Research Center, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4477-7121","authenticated-orcid":false,"given":"Kourosh","family":"Kazemi","sequence":"additional","affiliation":[{"name":"Abu Ali Sina Hospital for Medicine and Organ Transplantation Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4331-7262","authenticated-orcid":false,"given":"Seyed Mohammad Amir","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"issue":"6","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"e1128","DOI":"10.1542\/peds.2008-1363","article-title":"Outcomes of 5\u2010Year Survivors of Pediatric Liver Transplantation: Report on 461 Children From a North American Multicenter Registry","volume":"122","author":"Ng V. L.","year":"2008","journal-title":"Pediatrics"},{"issue":"6","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"648","DOI":"10.3748\/wjg.15.648","article-title":"Pediatric Liver Transplantation","volume":"15","author":"Spada M.","year":"2009","journal-title":"World Journal of Gastroenterology"},{"issue":"10","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.3727\/096368912X637505","article-title":"Clinical Outcome of Hepatocyte Transplantation in Four Pediatric Patients With Inherited Metabolic Diseases","volume":"21","author":"Ribes\u2010Koninckx C.","year":"2012","journal-title":"Cell Transplantation"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/j.1399-3046.2009.01246.x","article-title":"Biliary Strictures in Pediatric Liver Transplant Recipients\u2013Early Diagnosis and Treatment Results in Excellent Graft Outcomes","volume":"14","author":"Anderson C. D.","year":"2010","journal-title":"Pediatric Transplantation"},{"issue":"1","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s13104-024-06735-6","article-title":"Long\u2010Term Outcome of Combined Radiologic and Surgical Strategy for the Management of Biliary Complications After Pediatric Liver Transplantation","volume":"17","author":"Calinescu A. M.","year":"2024","journal-title":"BMC Research Notes"},{"issue":"4","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/den.12420","article-title":"Endoscopic Treatment of Pediatric Post\u2010Transplant Biliary Complications Is Safe and Effective","volume":"27","author":"Dech\u00eane A.","year":"2015","journal-title":"Digestive Endoscopy"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.anpede.2024.11.004","article-title":"Paediatric Endoscopy in Spain: Current Situation and Recent Developments","volume":"101","author":"Rubio M. N.","year":"2024","journal-title":"Anales de Pediatr\u00eda (English Edition)"},{"issue":"4","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.5223\/pghn.2022.25.4.332","article-title":"Endoscopic Retrograde Cholangiopancreatography in Bangladeshi Children: Experiences and Challenges in a Developing Country","volume":"25","author":"Rashid R.","year":"2022","journal-title":"Pediatric Gastroenterology, Hepatology & Nutrition"},{"issue":"5","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1002\/jpn3.12183","article-title":"Availability and Utilization of Endoscopic Retrograde Cholangiopancreatography at Children's Hospitals","volume":"78","author":"Pathak S. J.","year":"2024","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"issue":"7","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s00423-019-01804-y","article-title":"Endoscopic Treatment of Biliary Complications After Duct\u2010To\u2010Duct Biliary Anastomosis in Pediatric Liver Transplantation","volume":"404","author":"Harputluoglu M.","year":"2019","journal-title":"Langenbeck's Archives of Surgery"},{"issue":"3","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"E292","DOI":"10.1055\/a-1337-2212","article-title":"Endoscopic Retrograde Cholangiopancreatography in Infants and Children","volume":"9","author":"\u00c5vitsland T. L.","year":"2021","journal-title":"Endoscopy International Open"},{"issue":"12","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"3754","DOI":"10.4240\/wjgs.v16.i12.3754","article-title":"Analysis of the Efficacy and Safety of Endoscopic Retrograde Cholangiopancreatography for the Treatment of Pediatric Pancreatobiliary Diseases","volume":"16","author":"Wang X.\u2010Q.","year":"2024","journal-title":"World Journal of Gastrointestinal Surgery"},{"issue":"5","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1002\/lt.26379","article-title":"North American Biliary Stricture Management Strategies in Children After Liver Transplantation: A Multicenter Analysis From the Society of Pediatric Liver Transplantation (SPLIT) Registry","volume":"28","author":"Valentino P. L.","year":"2022","journal-title":"Liver Transplantation"},{"issue":"3","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","DOI":"10.1111\/petr.14727","article-title":"Biliary Strictures Post Pediatric Liver Transplantation\u2014Incidence and Risk Factors in a Single Tertiary Referral Transplant Center","volume":"28","author":"Vingrovich O.","year":"2024","journal-title":"Pediatric Transplantation"},{"issue":"3","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/tri.13091","article-title":"Endoscopic Retrograde Cholangio\u2010Pancreatography in the Management of Biliary Complications After Paediatric Liver Transplantation\u2013A Retrospective Study","volume":"31","author":"Karthik S. V.","year":"2018","journal-title":"Transplant International"},{"issue":"7","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","DOI":"10.1111\/petr.13271","article-title":"Endoscopic Treatment in Biliary Strictures After Pediatric Liver Transplantation","volume":"22","author":"Czubkowski P.","year":"2018","journal-title":"Pediatric Transplantation"},{"issue":"8","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1111\/j.1399-3046.2012.01771.x","article-title":"Endoscopic Retrograde Cholangiopancreatography Is Safe and Effective for the Diagnosis and Treatment of Pancreaticobiliary Disease Following Abdominal Organ Transplant in Children","volume":"16","author":"Otto A. K.","year":"2012","journal-title":"Pediatric Transplantation"},{"issue":"5","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/MPG.0b013e31829e0bb6","article-title":"Endoscopic Retrograde Cholangiopancreatography in the Pediatric Population Is Safe and Efficacious","volume":"57","author":"Enestvedt B. K.","year":"2013","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"2539","DOI":"10.2147\/IJGM.S513603","article-title":"Endoscopic Treatment and Outcome Analysis of Biliary Stricture After Orthotopic Liver Transplantation: A Single Center Retrospective Study","volume":"18","author":"Kong D.","year":"2025","journal-title":"International Journal of General Medicine"},{"issue":"1","key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1186\/s12893-025-03106-1","article-title":"Post\u2010Endoscopic Retrograde Cholangiopancreatography Cholangitis After Endoscopic Treatment of Post\u2010Transplant Biliary Strictures: A Retrospective Study","volume":"25","author":"Zhang C. C.","year":"2025","journal-title":"BMC Surgery"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70486","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70486","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:50:01Z","timestamp":1791777001000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/petr.70486"],"URL":"https:\/\/doi.org\/10.1111\/petr.70486","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":"2025-11-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70486"}}