Sakamoto, Seisuko
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: Intraoperative considerations in living liver donation—Guidelines from the ILTS–iLDLT group consensus conference 2025
Bhangui, Prashant , Hakeem, Abdul Rahman , Maira, Tommaso Di , Rammohan, Ashwin, Sayed, Blayne A. , Soejima, Yuji , Shingina, Alexandra , Cheah, Yee Lee , McCluskey, Stuart, Spiro, Michael , Ganesh, Swaytha , Rajalingam, Rajesh , Gupta, Subash , Findlay, James Y. , Chieh, Alfred Kow Wei, Sakamoto, Seisuko, Xia, Qiang, Kim, Ki-Hun , Polak, W., Soin, A G, Pomposelli, James J. , Vyas, Mary, Wiggins, Chantal, Mas, Valeria, Taner, Timucin, Broering, Dieter, Chen, Chao-Leng, Burra, Patrizia, Ascher, N. L., Lerut, Jan, Rela, Mohamed, Selzner, Nazia, Balci, Deniz, Olthoff, Kim M. , Polak, Wojciech G. , Hakeem, Abdul , Rammohan, Ashwin , Sayed, Blayne A , McCluskey, Stuart , Findlay, James, Sakamoto, Seisuko , Xia, Qiang , Polak, Wojciech G , Sapisochin, Gonzalo , Pomposelli, James , Selzner, Nazia , Balci, Deniz , Bhangui, Prashant , Di Maira, Tommaso , Gupta, Amar C. , Xia, Qiang , Sapisochín, Gonzalo , Soin, Arvinder S., Taner, Timuçin , Bröering, Dieter C. , Terrault, Norah A. , Burra, Patrizia , Hirschfield, Gideon M. , Lerut, Jan , Rela, Mohamed , Heimbach, Julie K. , Selzner, Nazia
Liver Transplantation | January 5, 2026 | Volume: 32 | Issue: 4 | Pages: 592-608
The success of living donor liver transplantation (LDLT) has bridged the growing gap between organ demand and availability in patients with liver failure or liver cancer. Safety of the living liver donor (LLD) is paramount, and astute intraoperative management plays a critical role in ensuring optimal outcomes for them. Given that intraoperative surgical and anesthesia practices vary widely across centers, the International Liver Transplantation Society (ILTS) and the International Living Donor Liver Transplantation Group (iLDLT Group) convened a global consensus conference in Toronto in March 2025 to develop guidelines for intraoperative management of the LLD. This manuscript details the recommendations on intraoperative considerations for the safety of LLD developed by Working Group II 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. Working Group II focused on intraoperative monitoring, fluid and ventilation strategies, surgical techniques for vascular and biliary division, surgeon and center-specific experience, and intraoperative crises planning. These guidelines aim to support both established and emerging LDLT teams to ensure high-quality and safe intraoperative care for the LLD.