Kasahara, Mureo

Mayo Clinic

National Center For Child Health and Development

Citations 2

Portal Vein Thrombosis in Pediatric Liver Transplantation With Technical Variant Grafts: An International Multicenter Analysis of Risk and Prognostic Factors

Raptis, Dimitri A., Gunasekaran, Vasanthakumar , Rammohan, Ashwin, Sakamoto, Seisuke, Uchida, Hajime, Beekum, Cornelius J. van, Krendl, F. J., Chen, Itsuko Chih-Yi, Domenick, Bryanna , Kow, Alfred, Soejima, Yuji, Furuya, Katryn N. , Mazariegos, George V., Dunn, Stephen, Olthoff, Kim, Rand, Elizabeth B. , Chen, C L, Balci, Deniz, Nadalin, Silvio, Schneeberger, Stefan, Sudan, Debra L., Schmelzle, Moritz, Herden, Uta , Fischer, L, Sayed, Blayne A., Ng, Vicky L, Kasahara, Mureo, Rela, Mohamed, Broering, Dieter C., Xia, Qiang, Clavien, P A, Li, Zhihao, Sudan, Debra L. , Li, Zhihao , Sayed, Blayne A , Sudan, Debra L , Li, Zhihao , Wang, Kaihang , Madadi‐Sanjani, Omid , Y, Liu , Raptis, Dimitri , Rammohan, Ashwin , Sakamoto, Seisuko , Uchida, Hajime , Kaliciński, Piotr , Goldaracena, Nicolás , Beekum, Cornelius J. van , Krendl, Felix Julius , Chen, Itsuko Chih-Yi, Kow, Alfred Wei Chieh , Soejima, Yuji , Mazariegos, George , Mali, Vidyadhar Padmakar , Leipnitz, Ian , Balci, Deniz , Kirimker, Elvan Onur , Nadalin, Silvio , Schneeberger, Stefan , Schmelzle, Moritz , Sayed, Blayne A. , Kowalewski, Grzegorz , Kasahara, Mureo , Rela, Mohamed , Bröering, Dieter C. , Xia, Qiang

Transplantation | June 9, 2026 | Volume: 110 | Issue: 8 | Pages: e1695-e1704

Background. The adoption of technical variant grafts has expanded the donor pool for pediatric liver transplantation, but it also poses a risk of portal vein thrombosis (PVT). This study evaluated risk and prognostic factors of PVT in children undergoing liver transplantation with technical variant grafts. Methods. A total of 3137 pediatric patients from 19 centers were included: 470 received split/reduced deceased donor grafts and 2667 received living donor grafts. Multivariable logistic regression was used to identify risk factors, whereas time-dependent Cox models were used to assess the impact on survival. Results. PVT occurred in 102 patients (3.3%) and was associated with increased mortality (adjusted hazard ratio, 2.86; 95% confidence interval [CI], 1.13-7.25; P = 0.027) and graft loss (adjusted hazard ratio, 9.97; 95% CI, 4.90-20.3; P < 0.001). Risk factors included younger age, lower weight, higher Pediatric End-Stage Liver Disease score, longer cold ischemia and operation times, higher graft-to-recipient weight ratio, increased red blood cell transfusions, and biliary atresia. After adjusting for center, lower weight (odds ratio, 0.84 per kg; 95% CI, 0.71-1.00; P = 0.047) and biliary atresia (odds ratio, 2.34; 95% CI, 1.10-5.00; P = 0.027) remained predictors. Five-year patient (88.4% versus 93.1%) and graft survival (82.7% versus 96.3%) were significantly inferior in patients with PVT. Conclusions. Low-weight children with biliary atresia constituted a high-risk group, highlighting the necessity for early detection and management.

Living liver donor safety: Early postoperative considerations of living liver donation guidelines from the ILTS-iLDLTG consensus conference

Sayed, Blayne Amir, Tejedor, Marta , Kathirvel, Manikandan , Bhangui, Prashant , Ghanekar, Anand, Kasahara, Mureo , Scatton, Olivier, Ghobrial, Mark, Klair, Tarunjeet , Rajakumar, Akila , Bezinover, Dimitri , Bittermann, Therese , Don, C, Luzzi, Carla , Tsien, Cynthia , Egawa, Hiroto , Ascher, Nancy L. , Bröering, Dieter C. , Chen, Chao‐Long , Lerut, Jan , Mas, Valeria R. , Taner, Timuçin , Vyas, Mary, Wiggins, Chantal, Olthoff, Kim M. , Rela, M, Selzner, Nazia, Sayed, Blayne A. , Bhangui, Prashant , Rammohan, Ashwin , Selzner, Nazia , Tejedor, Marta , Sayed, Blayne A , Chadha, Ryan , Ivanics, Tommy , Kim, Dong‐Sik , Scatton, Olivier , Ghobrial, Mark, Sudhindran, S , Benedetto, Fabrizio Di , Burra, Patrizia , Hirschfield, Gideon M. , Terrault, Norah A. , Wiggins, Chantal, Fung, John J. , Heimbach, Julie K. , Selzner, Nazia

Liver Transplantation | December 18, 2025 | Volume: 32 | Issue: 6 | Pages: 913-924

10.1097/lvt.0000000000000791

Living donor liver transplantation (LDLT) is a life-saving procedure for patients with end-stage liver disease. As its use expands worldwide, ensuring the safety and well-being of live liver donors (LLD) is of paramount importance. Published evidence on early postoperative complications after living donor hepatectomy—those occurring within 90 days of surgery—is limited, and standardized postoperative care protocols are lacking. The International Liver Transplantation Society (ILTS) and the International Living Donor Liver Transplantation Group (iLDLT Group) convened a consensus conference in Toronto in March 2025 to develop guidelines for the safe care of the LLDs. This manuscript details the recommendations on early postoperative considerations for the safety of LLDs developed by Working Group III (WGIII) of the Consensus Scientific Committee, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus. WGIII addressed four key areas: (1) standardized postoperative care, (2) early biliary complications, (3) early postoperative liver dysfunction, and (4) early postdischarge follow-up. This report emphasizes the need for vigilant postoperative monitoring in specialized units, with access to experienced providers and defined clinical pathways. Structured clinical and psychosocial follow-up protocols, perioperative prophylaxis for surgical site infections and venous thromboembolism, and management of early biliary and vascular complications are discussed. These may help standardize care, reduce complications and improve short-term outcomes in LLDs.