Pediatric Transplantation最新文献

{"title":"Flatter Tacrolimus Pharmacokinetic Profiles in Pediatric Kidney Transplant Recipients Receiving Liquid Formulations: A Quality Improvement Study.","authors":"Sarah Lafond, Mara Medeiros-Domingo, Sara Henderson, Dua Fayaz, Matthew Nichols, Guido Filler","doi":"10.1111/petr.70326","DOIUrl":"10.1111/petr.70326","url":null,"abstract":"<p><strong>Background: </strong>Compounded tacrolimus suspensions are frequently used in pediatric kidney transplant recipients who cannot reliably swallow capsules or who receive medication via a gastrostomy tube. Clinicians at our center observed unusually flat mini-pharmacokinetic (mini-PK) profiles in patients receiving liquid tacrolimus.</p><p><strong>Methods: </strong>We retrospectively analyzed 13 tacrolimus mini-PK profiles (C0, C1, C2, C4) from 7 pediatric kidney transplant recipients receiving compounded liquid tacrolimus, measured by LC-MS/MS in routine clinical care. As a contemporaneous comparator measured by the same assay, we assembled mini-PK profiles from pediatric recipients receiving capsule tacrolimus at our center (December 2024 onward). A historical capsule cohort from Berlin measured with Abbott Tacrolimus II immunoassay was used only as external context.</p><p><strong>Results: </strong>Contemporary LC-MS/MS capsule profiles showed the expected early post-dose rise, whereas liquid profiles remained comparatively flat across the 0-4 h window. In the historical capsule cohort, higher trough concentrations were associated with lower C_max/C_min ratios, consistent with a trough-dependent change in apparent PK shape.</p><p><strong>Conclusions: </strong>In this Quality Improvement (QI) analysis, pediatric patients receiving compounded liquid tacrolimus demonstrated flatter mini-PK profiles than contemporaneous capsule recipients when evaluated within the same analytical platform. These findings support closer attention to PK shape (not trough alone) in clinically complex children requiring liquid formulations and motivate prospective studies that control for gastrointestinal comorbidity, co-medications, and administration route.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 5","pages":"e70326"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal Clinically Important Difference for the PeLTQL in Pediatric Liver Transplantation: A Multicenter Analysis.","authors":"Vicky L Ng, Karina Kwan, Sherrie Logan, Julie Chessell, Steven J Lobritto, Evelyn K Hsu, Emily R Perito, Nitika A Gupta, Claire Dunphy, Daniel Pieratt, Lawrence C Kleinman, Eyal Shemesh, George V Mazariegos","doi":"10.1111/petr.70320","DOIUrl":"10.1111/petr.70320","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcomes are increasingly recognized as essential complements to biological indices in chronic disease including pediatric liver transplantation. However, clinicians lack clear thresholds to determine when changes in patient-reported outcome measure (PROM) scores represent clinically meaningful change. Establishing minimal clinically important difference (MCID) values is critical to interpret longitudinal PROM data and guide action. The Starzl Network Patient Reported Outcomes (SPaRO) study provided a unique opportunity to derive MCID estimates of the Pediatric Liver Transplant Quality of Life (PeLTQL) questionnaire.</p><p><strong>Methods: </strong>In SPaRO, English- or Spanish-speaking pediatric LT recipients aged 8-18 years and at least 1 year post-LT were recruited from 7 Starzl Network for Excellence in Pediatric Transplantation (SNEPT) sites. Participants and caregivers completed the PeLTQL (self- and proxy-report) questionnaire twice via a mobile application or web-based platform. MCIDs were estimated using anchor-based and distribution-based methods including predictive modeling.</p><p><strong>Results: </strong>A total of 98 patients and 86 caregivers completed two PeLTQL assessments between March 2022 and October 2023. Triangulated MCID values for the total score (TS) were 6.4 (self-report) and 5.6 (proxy-report). Predictive modeling yielded estimates of 7.7 (self) and 6.8 (proxy).</p><p><strong>Conclusions: </strong>In this multicenter cohort, MCID thresholds for the PeLTQL TS were approximately 6-8 points (self-report) and 6-7 points (proxy-report), consistent with prior single-center estimates. Changes in the PeLTQL TS of greater than 6 points may help clinicians identify patients who warrant closer attention. Prospective validation using an independent anchor is underway.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05241847.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 4","pages":"e70320"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity and Safety of Live Attenuated Varicella Vaccine in Children and Youth With Solid Organ Transplants in Canada: A Canadian Immunization Research Network Study.","authors":"Catherine Burton, Jo Lin Chew, Manish Sadarangani, Tom Blydt-Hansen, Soren Gantt, Shaun K Morris, Sneha Suresh, Anne Pham-Huy, Anthony Otley, Bruce Tapiero, Hana Mitchell, Juthaporn Cowan, Aida Sivro, Pierre-Philippe Piché-Renaud, Jeannette L Comeau, Karina A Top","doi":"10.1111/petr.70314","DOIUrl":"10.1111/petr.70314","url":null,"abstract":"<p><strong>Introduction: </strong>Children with solid organ transplants (SOT) face higher risks of severe disease from varicella-zoster virus (VZV). Although some guidelines recommend live attenuated varicella vaccine (LAVV) for select children post SOT, further real-world vaccine immunogenicity and safety data are needed.</p><p><strong>Methods: </strong>A prospective observational study was conducted at 4 Canadian centres from 2020 to 2023. Children who were 1-19 years, VZV IgG negative, > 1 year post liver, kidney, or heart transplant, and were receiving LAVV as part of clinical care in accordance with centre-specific criteria were eligible for inclusion. Measurement of VZV IgG was recommended post-vaccination with LAVV. Adverse events following immunization (AEFIs) were captured via telephone survey and chart review.</p><p><strong>Results: </strong>Fifty-six pediatric SOT recipients (51 liver, 3 kidney, and 2 heart) received ≥ 1 dose of LAVV. Serology after the last post-transplant dose of LAVV was available for 43/56 (77%) participants; 39/43 (91%) seroconverted to positive VZV IgG (12/16 after 1 post-transplant dose, 26/30 after 2 doses and 1/1 after 3 doses). Among 56 dose 1 recipients, 6 (11%) experienced an AEFI requiring medical attention. Four had rash: 3 with varicella-like rash (1/3 confirmed vaccine-strain varicella) and none required antivirals. Two had acute rejection 4-5 weeks after LAVV. Two of 38 (5%) dose 2 recipients had an AEFI requiring medical attention, with one serious AEFI 7 weeks after LAVV that was not deemed vaccine-related after careful review.</p><p><strong>Conclusions: </strong>LAVV was immunogenic and generally well tolerated in our cohort of patients. Post-SOT LAVV should be considered for select VZV seronegative children with close follow-up.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 4","pages":"e70314"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of POLD1 Deficiency With HSCT: Report of Two Years' Experience.","authors":"Sevgi Keles, Vedat Uygun, Mehmet Ali Karaselek, Serkan Küççüktürk, Oznur Dogar, Gunhal Satırtav, Seyma Celikbilek Celik, Bahadır Feyzioglu, Sukru Guner, Ismail Reisli, Gülsün Karasu, Akif Yeşilipek","doi":"10.1111/petr.70331","DOIUrl":"https://doi.org/10.1111/petr.70331","url":null,"abstract":"<p><strong>Background: </strong>POLD1 defect with immunodeficiency is characterized by T-cell and NK-cell lymphopenia, with the patients having a higher susceptibility to herpetic and viral respiratory tract infections. Patients considered for HSCT may be at increased risk of regimen-related toxicity due to impaired DNA repair. Here, we describe the first case of successful HSCT in a patient with POLD1 deficiency who presented at a relatively older age for immunodeficiency and underwent HSCT despite concerns about DNA-related toxicity from the conditioning regimen.</p><p><strong>Methods: </strong>We report the first successful HSCT in an 18-year-old woman with POLD1 deficiency who had recurrent pulmonary infections and shingles, and who was IgRT-dependent. The decision was made to perform HSCT from her matched related donor after informing the family that there was a concern about DNA-related toxicity following the HSCT procedure.</p><p><strong>Results: </strong>She underwent HSCT from a matched related donor using a reduced-intensity regimen (cyclophosphamide, fludarabine, ATG) with bone marrow and peripheral blood as stem cell sources. GVHD prophylaxis included tacrolimus and low-dose methotrexate. Engraftment occurred promptly, without major complications. Post-HSCT follow-up demonstrated improved T-cell counts and function, and the patient remained well without IgRT.</p><p><strong>Conclusion: </strong>This first report of HSCT in POLD1 deficiency shows that reduced-intensity conditioning can achieve engraftment with minimal toxicity, supporting HSCT as a feasible option for these patients. The success of HSCT will be understood more clearly as the cases are presented.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 5","pages":"e70331"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and Psychosocial Outcomes of Liver Graft Recipients Transplanted During Childhood.","authors":"Clara Gautier, Mado Gautier, Jessica Almeida Sousa, Kiswendsida Sawadogo, Catherine de Magnée, Roberto Tambucci, Giulia Jannone, Isabelle Scheers, Geraldine Dahlqvist, Xavier Stephenne","doi":"10.1111/petr.70324","DOIUrl":"10.1111/petr.70324","url":null,"abstract":"<p><strong>Background: </strong>While pediatric liver transplantation has markedly improved long-term survival, adult outcomes remain insufficiently explored beyond graft function, particularly regarding mental health and disease understanding-key dimensions of meaningful survival. To this aim, we evaluated psychosocial, behavioral, and lifestyle outcomes of adults who received a liver transplant during childhood, using validated tools.</p><p><strong>Methods: </strong>Fifty adult patients transplanted before 18 years of age at Cliniques Universitaires Saint-Luc completed an anonymous online questionnaire including measures of anxiety (STAI-Trait), depression (BDI-SF), and alcohol use (AUDIT), as well as questions on lifestyle, treatment adherence, and disease knowledge.</p><p><strong>Results: </strong>The results showed that clinically relevant anxiety and depressive symptoms were reported in 49% and 33% of respondents, respectively. Problematic alcohol use was found in 8% of participants, and 24% reported never receiving medical counseling about alcohol risks. Only 31% could correctly explain the pathophysiology of their liver disease, and 36% were unaware of its transmissible genetic nature. Despite these challenges, 76% were professionally or academically active.</p><p><strong>Conclusion: </strong>These findings highlight the persistence of high psychological distress and limited disease understanding into adulthood, supporting the integration of mental health screening and patient education into long-term post-transplant care.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 5","pages":"e70324"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious Complications After Percutaneous Transhepatic Biliary Drainage in Pediatric Liver Transplant Recipients.","authors":"Isaline Chabbey, Federico Barooty, Ana M Calinescu, Nicolas Silvestrini, Arnaud G L'Huillier, Barbara E Wildhaber, Sylvain Terraz, Valérie McLin, Nathalie Rock","doi":"10.1111/petr.70328","DOIUrl":"10.1111/petr.70328","url":null,"abstract":"<p><strong>Background: </strong>The gold-standard for the diagnosis and management of biliary complications, particularly biliary strictures in pediatric liver transplant (LT) recipients is percutaneous transhepatic cholangiogram (PTC) followed by biliary drainage (PTBD). Despite the established role of PTBD in managing biliary complications in pediatric LT recipients, limited data exist on post-procedural infection rates and optimal antibiotic prophylaxis strategies. The primary aim was to analyze the complications of PTBD in pediatric LT recipients. The secondary aim was to analyze factors associated with PTBD complications.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of children having undergone LT between August 2004 and October 2020 in our center. Patients who developed a biliary complication treated by PTBD were selected. We then compared PTBD patients with complications to those without.</p><p><strong>Results: </strong>Eleven patients underwent 35 percutaneous transhepatic biliary drainage (PTBD) sessions. Biliary atresia was the most frequent indication for LT in 6/11 (54%) children. Ten (10/11; 91%) received a left lateral segment, and all had undergone biliary-enteric anastomosis. Anastomotic stricture was the most common finding on PTC in 22/35 (63%) sessions. 25/35 (71%) PTBD were conducted using one-day antibiotic prophylaxis and 10/35 (29%) using extended-24-h antibiotherapy. Of 35 PTBD sessions, 17/35 (49%) experienced complications, primarily infectious (40%; 14/35). We compared different antibioprophylaxis regimens in 14 PTBD with infection. There was a trend to a lower incidence of infections in the extended-24-h antibiotherapy group (10%; 1/10) compared to the one-day antibiotic prophylaxis group (52%; 13/25) with a relative risk of 0.19 (0.03-1.28).</p><p><strong>Conclusions: </strong>PTBD is associated with a high rate of post-procedure infectious complications. These complications result in a high burden and morbidity. There was a trend to an association between extended-24-h antibiotherapy and the absence of infectious complications after PTBD.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 5","pages":"e70328"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Anti-HLA Antibody Desensitization Strategies in Pediatric Heart Transplant Recipients: A PHTS-PHIS Linkage Analysis.","authors":"Deipanjan Nandi, Robert J Gajarski, Hong Zhao, Ryan Cantor, James K Kirklin, Keisha Tully, Matt Hall, Justin Godown, Brian Birnbaum, Steven Zangwill, Rabia Khan, Joshua Friedland-Little","doi":"10.1111/petr.70315","DOIUrl":"10.1111/petr.70315","url":null,"abstract":"<p><strong>Purpose: </strong>Human Leukocyte Antigen (HLA) sensitization can adversely impact heart transplant (HTx) outcomes. We evaluated the effect of panel-reactive antibody (PRA) and desensitization (DS) strategies on outcomes of pediatric HTx recipients using a unique linkage between clinical registry and administrative databases.</p><p><strong>Methods: </strong>The Pediatric Heart Transplant Society (PHTS) registry was queried for all patients transplanted from January 2004 to March 2021 and linked by date of birth, HTx date, and center to the Pediatric Health Information System (PHIS). Class I and II PRA at listing, PRA at HTx, underlying diagnosis, age, gender, and graft loss were abstracted from PHTS. Inpatient DS therapy and associated charges were assessed via PHIS. Listed patients were divided by PRA into Low (< 10%), Medium (> 10% to less than median PRA for sensitized patients), and High (≥ median PRA for sensitized patients) cohorts for both Class I and II PRA. DS-related change in PRA category pre-HTx as well as 10-year graft survival were recorded.</p><p><strong>Results: </strong>We linked 3229 HTx recipients (87.5% of total PHTS cohort) with PHIS (45% female, 51% congenital heart disease). Among those with PRA > 10%, median Class I and II PRA was 36% and 48%, respectively. There were 223 High Class I and 191 High Class II patients. Of those with PRA > 10%, 10.8% received some DS therapy, including IVIg, rituximab, bortezomib, and/or plasmapheresis pre-HTx. DS therapies did not significantly alter absolute PRA or drive a change in PRA category from High to Low (p > 0.05). Patients with Low PRAs at listing had greater 10-year graft survival than those with High PRA (p < 0.05). DS therapy did not improve graft survival among patients who were highly sensitized at listing (Figure). Median pharmacy DS charges were $9.9 K (IQR $3.9 K-$28.4 K).</p><p><strong>Conclusion: </strong>Elevated PRA adversely impacts graft survival in pediatric HTx recipients. Efficacy of the studied DS therapies in this limited cohort was inconsistent. In patients highly sensitized at listing, efforts at DS are not associated with improved outcomes. Given cost and morbidity associated with DS, careful assessment of risks and benefits for individual patients is warranted.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 4","pages":"e70315"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Refractory Hyperammonemia due to Pediatric Acute Liver Failure Treated With Two-Site Blood Purification Devices Prior to Liver Transplantation.","authors":"Soichiro Tanimura, Kentaro Ide, Shotaro Matsumoto, Hajime Uchida, Seisuke Sakamoto, Mureo Kasahara","doi":"10.1111/petr.70308","DOIUrl":"10.1111/petr.70308","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation remains the established treatment for pediatric acute liver failure (PALF). Continuous hemodiafiltration (CHDF) and plasma exchange (PE) are implemented as bridging therapies to liver regeneration or liver transplantation. We report a pediatric case in which conventional CHDF failed to optimize ammonia levels, yet management using two blood purification devices successfully rescued the patient without neurological sequelae.</p><p><strong>Case presentation: </strong>The patient was a 6-year-old boy. Upon transfer, the patient exhibited drowsiness and disorientation. Laboratory tests showed AST 387 IU/L, ALT 579 IU/L, total bilirubin 8.9 mg/dL, ammonia levels 92 μg/dL, and PT-INR 2.6. EEG revealed generalized slowing. Encephalopathic PALF was diagnosed. On admission, ammonia was 92 μg/dL, which rapidly increased to 281 μg/dL prior to initiation of CHDF. Despite intensification of dialysis parameters and addition of pharmacotherapy, ammonia levels remained above 200 μg/dL until the following day. Therefore, an additional 11 Fr dialysis catheter was placed in the right femoral vein, and CHDF management was conducted using two blood purification devices. As a result, ammonia levels dropped below 150 μg/dL within approximately 5 h and were maintained thereafter (maximum settings: dialysate flow 16 000 mL/h, convective substitution volume 4000 mL/h). Electroencephalography (EEG) showed generalized slowing resolved, and consciousness gradually improved. After living donor liver transplantation (LDLT), the patient was extubated on postoperative day 1 and was fully conscious and clinically stable by postoperative day 9, at which point he was transferred to the general ward.</p><p><strong>Conclusion: </strong>Management using two-site blood purification devices was an effective method for controlling refractory hyperammonemia.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 4","pages":"e70308"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utilization of FibroScan in Pediatric Liver Transplant at a Single Tertiary Center.","authors":"Chaowapong Jarasvaraparn, Iván A González, Ishanpreet Singh Sran, Brendan P Anderson, Kyla Tolliver, Richard Shane Mangus, Chandrashekhar Avinash Kubal, Jean P Molleston","doi":"10.1111/petr.70325","DOIUrl":"10.1111/petr.70325","url":null,"abstract":"<p><strong>Objectives: </strong>Liver biopsy remains the gold standard to evaluate fibrosis. Vibration-controlled transient elastography (VCTE) utilizing FibroScan allows for non-invasive measurement of liver stiffness in liver transplant (LT) recipients. This study investigated the utilization of FibroScan in pediatric liver transplant recipients.</p><p><strong>Methods: </strong>In a retrospective single-center analysis of children with LT who underwent at least one FibroScan, we investigated the correlation of biomarkers such as controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) from FibroScan with the severity of steatosis and fibrosis on liver biopsy. Advanced fibrosis (AF) was defined as bridging fibrosis and/or cirrhosis (fibrosis score 3-4) on liver biopsy.</p><p><strong>Results: </strong>A total of 166 FibroScans from 74 children with LT (10 split and 64 whole liver) were included. Forty-seven children underwent liver biopsies. LSM was significantly correlated with AF (r = 0.63, p = 0.001). LSM greater than 7.9 kPa predicted AF with AUC 0.96% and 99% sensitivity, 84% specificity (p = 0.001). The 11 children with CAP ≥ 225 dB/m did not have any biopsy evidence of steatosis. Split liver recipients had significantly higher LSM than whole liver recipients (10.4 vs. 5.9 kPa, p = 0.05).</p><p><strong>Conclusions: </strong>VCTE is a practical tool to assess graft fibrosis in children with LT. Split livers have higher LSM measurement, which does not correlate with AF on biopsy. We speculate that VCTE can be useful for graft fibrosis surveillance in children with LT.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 4","pages":"e70325"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering the Interpretation and Clinical Implications of Adenovirus Disease After Pediatric Liver Transplantation.","authors":"Teruhiko Imamura","doi":"10.1111/petr.70333","DOIUrl":"https://doi.org/10.1111/petr.70333","url":null,"abstract":"","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 5","pages":"e70333"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}