Evidence map›Paper›PMID 42700228›Full record

ArticlePediatric surgery international2026

The clinical features and outcomes of acute-on-chronic liver failure in biliary atresia patients on a waiting list for liver transplantation.

Toshiharu Matsuura, Yukihiro Toriigahara, Shohei Maeda, Yoshiaki Takahashi, Atsuhisa Fukuta, Naonori Kawakubo, Koichiro Yoshimaru, Kouji Nagata, Tatsuro Tajiri

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Article in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Toshiharu MatsuuraDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. matsuura.toshiharu.809@m.kyushu-u.ac.jp.
Yukihiro ToriigaharaDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Shohei MaedaDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Yoshiaki TakahashiDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Atsuhisa FukutaDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Naonori KawakuboDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Koichiro YoshimaruDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Kouji NagataDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Tatsuro TajiriDepartment of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAcute-on-chronic liver failure (ACLF) in adults has an extremely poor prognosis. However, reports on the epidemiology and outcomes of ACLF in biliary atresia (ACLF-BA) are scarce.

methodsAmong 123 BA cases deemed eligible for liver transplantation (LT), we retrospectively evaluated them according to the Japanese ACLF diagnostic criteria established in 2018 and categorized them into ACLF-BA and non-ACLF-BA groups. We also retrospectively reviewed the liver and extrahepatic organ failures during the waitlist period in both groups.

resultsFourteen patients (11.4%) were categorized as ACLF-BA. The liver function in ACLF-BA dramatically worsened both in the Child-Pugh and MELD scores in the short term after ACLF onset. Seven cases (50%) in ACLF-BA were categorized as grade 3 with more than three extrahepatic organ failures. The waitlist mortality rate for deceased donors in ACLF-BA was as high as 50%. However, the post-LT patient survival rate in ACLF-BA was 90.9%, and not statistically significantly different compared to non-ACLF-BA.

conclusionAlthough ACLF-BA awaiting LT carries an increased waitlist mortality, the post-LT patient survival was comparable to recipients without ACLF. The type and number of extrahepatic organ failures could correlate with patient mortality. The prioritization of organ allocation for ACLF-BA warrants further discussion.

Indexed as

Acute-On-Chronic Liver FailureBiliary AtresiaLiver TransplantationWaiting ListsChildChild, PreschoolFemaleHumansInfantMalePrognosisRetrospective StudiesSurvival RateTreatment OutcomeAcute-on-chronic liver failureBiliary atresiaextra-hepatic organ failureLiver transplantation

Identifiers

PMID42700228

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.