{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:48:28Z","timestamp":1791614908787,"version":"4.3.4"},"reference-count":12,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"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"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Posttransplant complications in pediatric patients, including rejection, infection, drug toxicity, and nonadherence, are still frequently identified at a late stage, when biomarkers have already changed and clinically meaningful harm to the graft or the patient may already be established. Current follow\u2010up models remain overly dependent on laboratory tests, episodic visits, and reactive responses to overt deterioration, while underrecognizing subtle clinical signals perceived by nurses and caregivers over time. This viewpoint proposes the Nurse\u2010as\u2010Sensor Framework, in which nurses act as clinical sensors capable of detecting early \u201csoft signals,\u201d and operationalizes it through a Longitudinal Nursing Surveillance Model, combining structured nursing consultations, remote microcontacts, a brief standardized checklist, a dynamic risk score, and graduated response pathways. We argue that this model can be implemented immediately with simple resources, increase screening sensitivity, accelerate diagnostic workup, and strengthen nursing autonomy in pediatric posttransplant care.<\/jats:p>","DOI":"10.1111\/petr.70489","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:50:12Z","timestamp":1791611412000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Nurse as an Early Warning System: A Longitudinal Surveillance Model in Pediatric Transplantation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8767-7556","authenticated-orcid":false,"given":"Jo\u00e3o Daniel de Souza","family":"Menezes","sequence":"first","affiliation":[{"name":"S\u00e3o Jos\u00e9 Do Rio Preto Medical School (FAMERP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4569-2808","authenticated-orcid":false,"given":"Matheus Querino da","family":"Silva","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Do Rio Preto Medical School (FAMERP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9513-1083","authenticated-orcid":false,"given":"Emerson Roberto dos","family":"Santos","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Do Rio Preto Medical School (FAMERP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikaell Alexandre Gouvea","family":"Faria","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Do Rio Preto Medical School (FAMERP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0549-4527","authenticated-orcid":false,"given":"J\u00falio C\u00e9sar","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Do Rio Preto Medical School (FAMERP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita de C\u00e1ssia Hel\u00fa Mendon\u00e7a","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"S\u00e3o Jos\u00e9 Do Rio Preto Medical School (FAMERP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_23_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/NURSREP15060202"},{"key":"e_1_2_23_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/27527530221147886"},{"key":"e_1_2_23_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12887\u2010025\u201006444\u20104"},{"key":"e_1_2_23_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X20942632"},{"key":"e_1_2_23_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/PETR.14152"},{"key":"e_1_2_23_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004660"},{"key":"e_1_2_23_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/TI.2024.13192\/TEXT"},{"key":"e_1_2_23_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/PETR.70318"},{"key":"e_1_2_23_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/PETR.70103"},{"key":"e_1_2_23_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/PETR.14106"},{"key":"e_1_2_23_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/PETR.13235"},{"key":"e_1_2_23_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/CTR.70106"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70489","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70489","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:50:13Z","timestamp":1791611413000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":12,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/petr.70489"],"URL":"https:\/\/doi.org\/10.1111\/petr.70489","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":"2026-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70489"}}