{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:06:40Z","timestamp":1789736800079,"version":"4.0.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Despite advances in medical therapy, liver replacement continues to be the only definitive mode of therapy for children with end-stage liver disease (ESLD). However, its acceptance in India has been discouraging more due to financial and logistic reasons than the availability of expertise. This report outlines our journey and highlights issues pertinent to circumstances in an emerging economy like India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim is to review a single center\u2019s 100 case experience with liver transplantation (LT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A prospective analysis of all children who underwent LT since 2005 at our institute was done. The data were collated from a maintained structured database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Hundred children underwent LT. Sixty-four were boys. Age ranged from 5 to 144 months, with a median of 17 months. The mean weight of the cohort was 7.5 kg (ranging from 3.7 to 31.5 kg), with 60% of our children weighing between 5 and 10 kg. Biliary atresia is the most common indication (57%); others include metabolic disorders, progressive familial intrahepatic cholestasis, and hepatoblastoma. Two patients were for acute liver failure. Ninety-one children underwent live donor LT (mothers being the majority of the donors). None of the donors had any major postoperative complications. Major intraoperative complications include sepsis (39%), vascular complications (17%), biliary leak (11%), and intestinal complications (11%). Early postoperative deaths occurred in 18% of patients with sepsis being most common cause. The mean follow-up was 8.5 years and the overall survival is 70%. The mean survival is time (months) = 176.1. All surviving patients were followed up and had achieved good catch up growth by 3rd and 5th years posttransplant. The long-term sequalae include recurrent intercurrent infections, graft rejection (9%), posttransplant lymphoproliferative disease (5%), and portal vein stenosis (5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our experience demonstrates the feasibility of LT in children with ESLD in India. With longer-living grafts, patients often struggle with other issues such as compliance with follow-up, financial issues, recurrent infections, and neurological problems. Close monitoring with regular follow-up of patients helps in early recognition and treatment of late-onset complications, thus helping the overall long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_229_23","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T15:00:27Z","timestamp":1715180427000},"page":"192-198","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Transplanting Livers in Young Children \u2013 Looking Back at 100 Cases"],"prefix":"10.4103","volume":"29","author":[{"given":"Reya Rachel","family":"Abraham","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, Narayana Health City, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Zameer","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Narayana Health City, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Vinay","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Narayana Health City, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Narayana Health City, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"D\u2019Cruz","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Narayana Health City, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"key":"R1-20240905","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/lt.24640","article-title":"Biliary atresia:Indications and timing of liver transplantation and optimization of pretransplant care","volume":"23","author":"Sundaram","year":"2017","journal-title":"Liver Transpl"},{"key":"R2-20240905","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.jhep.2006.11.006","article-title":"Liver transplantation in children","volume":"46","author":"Muiesan","year":"2007","journal-title":"J Hepatol"},{"key":"R3-20240905","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1136\/archdischild-2015-310023","article-title":"Liver transplantation in children:State of the art and future perspectives","volume":"103","author":"Kohli","year":"2018","journal-title":"Arch Dis Child"},{"key":"R4-20240905","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/S0031-3955(03)00150-0","article-title":"Current status of liver transplantation in children","volume":"50","author":"McDiarmid","year":"2003","journal-title":"Pediatr Clin North Am"},{"key":"R6-20240905","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1097\/00007890-200210270-00012","article-title":"Long-term outcome of liver retransplantation in children","volume":"74","author":"Deshpande","year":"2002","journal-title":"Transplantation"},{"key":"R7-20240905","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jpeds.2020.06.053","article-title":"Decreased incidence of hepatic artery thrombosis in pediatric liver transplantation using technical variant grafts:Report of the society of pediatric liver transplantation experience","volume":"226","author":"Ebel","year":"2020","journal-title":"J Pediatr"},{"key":"R8-20240905","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4254\/wjh.v8.i1.36","article-title":"Vascular complications following liver transplantation:A literature review of advances in 2015","volume":"8","author":"Piardi","year":"2016","journal-title":"World J Hepatol"},{"key":"R9-20240905","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1600-6143.2008.02541.x","article-title":"Early hepatic artery thrombosis after liver transplantation:A systematic review of the incidence, outcome and risk factors","volume":"9","author":"Bekker","year":"2009","journal-title":"Am J Transplant"},{"key":"R10-20240905","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1016\/j.transproceed.2006.02.094","article-title":"Vascular complications after pediatric liver transplantation from the living donors","volume":"38","author":"Broniszczak","year":"2006","journal-title":"Transplant Proc"},{"key":"R11-20240905","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1046\/j.1399-3046.2003.00127.x","article-title":"Biliary complications of living related pediatric liver transplant patients","volume":"8","author":"Kling","year":"2004","journal-title":"Pediatr Transplant"},{"key":"R12-20240905","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.4254\/wjh.v7.i18.2162","article-title":"Biliary complications after pediatric liver transplantation:Risk factors, diagnosis and management","volume":"7","author":"Feier","year":"2015","journal-title":"World J Hepatol"},{"key":"R13-20240905","doi-asserted-by":"crossref","first-page":"3524","DOI":"10.1016\/j.transproceed.2013.09.012","article-title":"Biliary complications after pediatric liver transplantation","volume":"45","author":"Karakayal\u0131","year":"2013","journal-title":"Transplant Proc"},{"key":"R14-20240905","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s001470050146","article-title":"Bowel perforation after paediatric orthotopic liver transplantation","volume":"11","author":"Vilca Melendez","year":"1998","journal-title":"Transpl Int"},{"key":"R15-20240905","doi-asserted-by":"crossref","first-page":"207","DOI":"10.5223\/pghn.2013.16.4.207","article-title":"Long term outcomes after pediatric liver transplantation","volume":"16","author":"Yazigi","year":"2013","journal-title":"Pediatr Gastroenterol Hepatol Nutr"},{"key":"R16-20240905","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1002\/lt.20358","article-title":"Long-term outcome of pediatric liver transplantation for biliary atresia:A 10-year follow-up in a single center","volume":"11","author":"Fouquet","year":"2005","journal-title":"Liver Transpl"},{"key":"R17-20240905","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/0976001620070414","article-title":"Liver transplantation:Experience with last 50 cases at our centre","volume":"4","author":"Wadhawan","year":"2007","journal-title":"Apollo Med"},{"key":"R18-20240905","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/0971-9261.74512","article-title":"Pediatric liver transplantation:A report from a pediatric surgical unit","volume":"16","author":"Rao","year":"2011","journal-title":"J Indian Assoc Pediatr Surg"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_229_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:31:11Z","timestamp":1787769071000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_229_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_229_23","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2023-10-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}