{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:07:38Z","timestamp":1791896858082,"version":"4.3.4"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>Over four decades, pediatric liver transplantation represents a major medical achievement. Graft function and biochemical stability alone no longer define success. Recent data show that only a minority of long-term survivors meet composite criteria for \u201cmeaningful\u201d survival, which includes psychological wellbeing, social integration, and treatment adherence. Growing up with a transplant shapes identity, autonomy, and life trajectory. Although many recipients achieve education, employment, and parenthood, patient-reported outcomes reveal persistent psychological distress, reduced health-related quality of life, and ongoing vulnerability. Mental health symptoms, limited health literacy, and gaps in disease understanding may compromise adherence and long-term outcomes. Substance use, while not necessarily more prevalent than in the general population, carries disproportionate risks in this fragile group and underscores the need for early, structured prevention. Transition from pediatric to adult care represents a critical pivotal and formative period, marked by increased risk of nonadherence and graft complications or graft loss, but also a unique opportunity to strengthen autonomy, psychoeducation, and self-management skills. We argue for a paradigm shift toward lifelong, multidisciplinary follow-up integrating psychological screening, structured transition pathways, and sustained health education. Pediatric transplantation has created long-term survivors. The next challenge is to ensure they become informed, autonomous, and psychologically supported adults.<\/jats:p>","DOI":"10.3389\/ti.2026.16481","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:00:21Z","timestamp":1782280821000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From graft survival to life: redefining success after pediatric liver transplantation"],"prefix":"10.3389","volume":"39","author":[{"given":"Geraldine","family":"Dahlqvist","sequence":"first","affiliation":[{"name":"Cliniques universitaires Saint-Luc, Service d\u2019h\u00e9patogastroent\u00e9rologie","place":["Brussels, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Gautier","sequence":"additional","affiliation":[{"name":"Cliniques universitaires Saint-Luc, Service de gastro-p\u00e9diatrie","place":["Brussels, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Stephenne","sequence":"additional","affiliation":[{"name":"Cliniques universitaires Saint-Luc, Service de gastro-p\u00e9diatrie","place":["Brussels, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1097\/SLA.0b013e3181f5f23a","article-title":"Long-term patient outcome and quality of life after liver transplantation: analysis of 20-year survivors","volume":"252","author":"Duffy","year":"2010","journal-title":"Ann Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1756","DOI":"10.1097\/TP.0000000000004556","article-title":"Long-term outcome of pediatric liver transplant recipients who have reached adulthood: a single-center experience","volume":"107","author":"Lund","year":"2023","journal-title":"Transplantation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"100987","DOI":"10.1016\/j.eclinm.2021.100987","article-title":"Outcomes of adults who received liver transplant as young children","volume":"38","author":"Vimalesvaran","year":"2021","journal-title":"EClinicalMedicine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"27","DOI":"10.6002\/ect.PediatricSymp2022.L16","article-title":"Pediatric liver transplantation: long-term Follow-Up issues","volume":"20","author":"Bellini","year":"2022","journal-title":"Exp Clin Transpl Off J Middle East Soc Organ Transpl"},{"key":"B5","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/j.jpeds.2011.10.038","article-title":"Health status of children alive 10 years after pediatric liver transplantation performed in the US and Canada: report of the studies of pediatric liver transplantation experience","volume":"160","author":"Ng","year":"2012","journal-title":"J Pediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e70324","DOI":"10.1111\/petr.70324","article-title":"Epidemiological and psychosocial outcomes of liver graft recipients transplanted during childhood","volume":"30","author":"Gautier","year":"2026","journal-title":"Pediatr Transpl"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1002\/lt.25792","article-title":"Liver transplant survivorship","volume":"26","author":"Lai","year":"2020","journal-title":"Liver Transpl"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.socscimed.2016.11.015","article-title":"Constructing embodied identity in a \u2018new\u2019 ageing population: a qualitative study of the pioneer cohort of childhood liver transplant recipients in the UK","volume":"172","author":"Lowton","year":"2017","journal-title":"Soc Sci Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e13782","DOI":"10.1111\/petr.13782","article-title":"What is the long-term outlook for young people following liver transplant? 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