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The detection of the aneurysms were suggestive of MIS-C.[6] Unlike other reported cases of MIS-C,[7] the cardiac involvement in our patient was restricted to coronary aneurysms, and myocardial function was unaltered. Multisystem inflammatory syndrome in children (MIS-C) associated with SARS-COV-2 in the immediate post-transplant period Abbreviations RT-PCR reverse transcription polymerase chain reaction IVIG intravenous immunoglobulin LT liver transplant MIS-C multisystem inflammatory syndrome in children POD postoperative day INTRODUCTION In 2020, after the outbreak of SARS-COV-2 pandemic, increasing reports of children developing multisystem inflammatory conditions following the acute phase of COVID-19 emerged. [Extracted from the article]

eHAT is one of the most dreaded post‐LT complication. Treatment approaches include retransplantation, revascularization, or observation. Systemic thrombolytic therapy is used in pediatric patients with thromboembolic events. However, there is no previous study reporting on the use of systemic r‐tPA to treat eHAT. The treatment strategies used in patients with eHAT are described, focusing on two children who failed SR and were treated with systemic heparinization plus systemic r‐tPA infusion. r‐tPA‐RP consists of intravenous systemic infusion at a dose of 0.3 mg/kg/h during 6 hours, for 5 days. First case (3‐year) was transplanted with a whole liver, and second case (6‐year) received a LLS from a living donor. HAT was diagnosed by doppler US and confirmed by angioCT scan in both patients in the first day after LT. They underwent SR and were clinically stable. Re‐thrombosis occurred in both patients the day after, and r‐TPA‐RP was started—one patient required two r‐TPA‐RP for HAT recurrence. They presented minor bleeding, without repercussion. Hepatic artery recanalized after 10 and 3 days in the first and second patient, respectively. Retransplant was avoided, and one developed biliary strictures, successfully managed in the follow‐up. r‐TPA‐RP avoided retransplantation after eHAT in these cases. To our knowledge, this is the first report of the use of systemic r‐TPA to treat eHAT in children. This strategy may compose an algorithm to treat eHAT that failed SR in stable patients. [ABSTRACT FROM AUTHOR]

It is uncertain whether prior Kasai procedures negatively impact the outcomes of liver transplantation (LT). The prior meta-analysis did not distinguish between Kasai early failure (K-EF) and late failure (K-LF). Numerous studies have been recently published; therefore, we perform a systematic review and meta-analysis. We searched PubMed and Embase databases to identify studies comparing the outcomes of biliary atresia (BA) patients undergoing primary LT versus patients with prior Kasai procedures. Subgroup analysis was done at the time of Kasai failure (early vs. late). Twenty-five studies comprising 6,408 patients receiving LT were included in the analysis. We found a statistically significant increase in one-year graft survival in K-LF versus primary liver transplant (pLT) (P = 0.0003). One-year patient survival was also increased in K-LF, although not statistically significant (P = 0.09). No difference in the one- and five-year graft and patient survival, reoperation rate, infection, and biliary complication was seen in pLT vs overall prior Kasai (K-EF and K-LF). These results suggest that prior kasai procedure does not negatively impact the outcome of LT. In addition, BA patients with prior Kasai undergoing LT later in life tend to perform better than primary liver transplants., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sanha et al.)

Anatomic hepatectomies are resections in which compromised segments or sectors of the liver are extracted according to the topological structure of its vascular elements. Such structure varies considerably among patients, which makes the current anatomy-based planning methods often inaccurate. In this work we propose a strategy to efficiently and semi-automatically segment and classify patient-specific liver models in 3D. The method is based on standard CT datasets and allows accurate estimation of functional remaining liver volume. Experiments showing effectiveness of the method are presented, and quantitative and qualitative results are discussed.