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: Preoperative aspects of living liver donation—Guidelines from the ILTS–iLDLT consensus conference
Patel, Madhukar , Magistri, P., Sayed, Blayne A. , Rammohan, Ashwin, Humar, Abhinav, Abbey, Susan , Badenoch, Heather, Bhangui, Pooja , Cattral, M C, Durand, F., Hibi, Taizo, Jhaveri, Kartik , Kabacam, Gokhan, Khan, Maaz , Malik, Ashish, Nadalin, S., Ng, Vicky L, Petrowsky, Henrik , Pillai, Anjana , TOKAT, YAMAN, Wong, Tiffany, Yilmaz, Sezai, Yoshizumi, T., Nl, Ascher, Broering, Dieter, Burra, Patrizia, Chen, Chao-Long, Lerut, J., Mas, Valeria R. , Taner, Timucin, Terrault, Norah, Vyas, Mary, Wiggins, Chantal, Heimbach, Julie, Ng, Vicky L. , Rela, M., Patel, Madhukar S. , Selzner, Nazia , Sayed, Blayne A , Rammohan, Ashwin , Humar, Abhinav , Abbey, Susan , Ng, Vicky L , Rela, Mohamed , Bhangui, Prashant , Selzner, Nazia , Khan, Mohammad Qasim , Magistri, Paolo , Humar, Abhinav , Cattral, Mark S. , Durand, François , Gross, Jed Adam , Hibi, Taizo , Kabaçam, Gökhan , Malik, Ashish , Nadalin, S., Reddy, Mettu Srinivas , Wong, Tiffany, Yilmaz, Sezai , Yoshizumi, Tomoharu , Bröering, Dieter C. , Burra, Patrizia , Hirschfield, Gideon M. , Taner, Timuçin , Terrault, Norah A. , Heimbach, Julie K. , Rela, Mohamed , Bhangui, Prashant
Liver Transplantation | January 9, 2026 | Volume: 32 | Issue: 7 | Pages: 1049-1065
Living donor liver transplantation (LDLT) is an established therapy with curative intent for pediatric and adult patients with acute liver failure and end-stage liver disease. Donor safety remains paramount and commences during preoperative evaluation and assessment. Given the importance of the topic, the International Liver Transplantation Society and International Living Donor Liver Transplantation Group consensus conference on Living Liver Donor Safety was convened in March 2025 (Toronto, Canada). Recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus was followed. This report presents 28 recommendations from the working group focused on addressing clinically relevant questions related to the preoperative aspects of living donor safety including assessment of donor acceptability (age, body mass index and hepatic steatosis; medical conditions and contraindications), medical and surgical workup (liver function and procoagulant workup; anatomical considerations and safe remnant), and psychosocial evaluation (timing and team; underlying conditions; non-directed, paired, and anonymous directed donors; urgent living donor workups for acute liver failure).