Digital Commons Network^™

Missing The Target: A Scoping Review Of The Use Of Percent Weight Loss For Obesity Management, Diana Sherifali, Megan Racey, Donna Fitzpatrick-Lewis, Michelle Greenway, Sanjeev Sockalingam, Jun Wada, Soo Huat Teoh, Ian Patton, David Macklin, Elizabeth F C Van Rossum, Luca Busetto, Deborah Bade Horn, J D Patricia Nece, Morgan Emile Gabriel Salmon Leguede, Nicole Pearce, Carel Le Roux, Jamy Ard, Angela S Alberga, Lee Kaplan, Arya M Sharma, Sean Wharton

Faculty, Staff and Student Publications

Introduction: To co-create comprehensive targets for obesity management, we need to understand the genesis and current use of percent weight loss targets in research. The goals of our scoping review are to (1) synthesize the literature on percent weight loss targets for adults with obesity and (2) discuss the percent weight loss targets in context with their health benefits.

Methods: We searched Cochrane, MEDLINE, and EMBASE for English language, pharmaceutical, and/or behavioral intervention studies in adults with obesity where the explicit aim of the study was weight reduction defined as a percent of body weight. Reviewers screened citations and extracted …

Evidence-Informed Propositions For A Whole-Of-Program Assessment Approach, Janica Jamieson, Rachel Bacon, Andrea Bramley, Janeane Dart, Simone Gibson, Gemma Jenkins, Meredith Kennedy, Sue Kleve, Claire Palermo

Research outputs 2022 to 2026

Aim: To develop evidence-informed propositions for implementing whole-of-program assessment across dietetic education settings, in response to emerging education theory, technological advances such as generative artificial intelligence, and the need for meaningful learning and trustworthy progression decisions. Methods: A four-stage multiple methods study, grounded in pragmatism, was conducted. Initial propositions were developed through a systematic scoping review of programmatic assessment literature. Thematic analysis was used to identify patterns, which were iteratively refined into themes and then preliminary propositions. These were further refined through workshops with dietetic educators, who provided feedback based on their expertise. A repeated systematic scoping review incorporated recent …

Testing If Vitamin K1 Reduces The Progression Of Non-Severe Calcific Aortic Stenosis: Design And Rationale Of The Prevention Of Aortic Stenosis Progression Phylloquinone Ossification Reduction Trial (Passport), William A. Courtney, Jarryd Walker, Aindreas Dorai-Raj, Tom Gilbert, Adil Rajwani, Jamie W. Bellinge, Jonathan M. Hodgson, Graham S. Hillis, Carl J. Schultz

Research outputs 2022 to 2026

Aims Calcific aortic stenosis (CAS) is the most common heart valvulopathy in high-income countries. There is no known treatment for CAS other than replacement of the valve in severe, symptomatic disease. Observational studies and a small openlabel randomized trial have reported that vitamin K1 supplementation may reduce the progression rate of calcification and obstruction in CAS. Methods and results 3PASSPORT(ACTRN12622000447752) will be a prospective, randomized, double-blind, placebo-controlled clinical trial investigating if nutritional supplementation with 10 mg of vitamin K1 can reduce the rate of valvular calcification and haemodynamic progression in CAS. Patients identified to have mild or moderate CAS based …

Paclobutrazol Enhances Tall Fescue Salt Tolerance Via Physiological And Root System Architecture Modulation, Shugao Fan, Xindi Sun, Guohao Liang, Zhuanzhuan Ma, Jincheng Hao, Jiawei Wu, Ying Zhao

School of Mathematical & Statistical Sciences Faculty Publications

Background: Salinity represents a major global constraint on crop productivity. Promoting the cultivation of tall fescue in saline environments offers not only nutritional advantages for livestock but also enhances its potential for ornamental use. In this mesocosm study, we examined the effects of paclobutrazol (PBZ) on tall fescue performance under salt stress, focusing on key physiological traits to evaluate salt tolerance.

Results: Under high salt stress, paclobutrazol application increased the total number of lateral roots by 85%, from 18.39 to 34.04, and widened their growth angle by 24%, from 24.10° to 29.88°, fundamentally enhancing topsoil exploration. This reconfigured root system …

Enhanced Recovery After Neurosurgery: A Narrative Review Comparing Clinical Outcomes, Protocols, And Challenges With Standard Postoperative Care, Tirath Patel, Hamza Yousuf Ibrahim, Rahma Naveed, Aziz Ur Rehman, Maryam Amir, Fatima Nasir, Anum Zia Khan, Nikhilesh Anand

School of Medicine Publications

Background: By integrating evidence-based pre-, intra-, and postoperative therapies, enhanced recovery after surgery (ERAS) protocols have transformed perioperative care in numerous surgical specialties. Although their use in neurosurgery aims to maximize patient recovery, minimize complications, and reduce hospital stays, the evidence remains heterogeneous, and large randomized controlled trials are scarce.

Objectives: This narrative review contrasts the clinical outcomes, advantages, and challenges of ERAS protocols with those of conventional postoperative care in neurosurgery, with a focus on cranial, spinal, pediatric, cancer, and functional procedures.

Methods: A thematic synthesis of peer-reviewed clinical evidence was conducted using PubMed, Scopus, and Google Scholar (2000-2025). …

Metabolic Flexibility As A Candidate Mechanism For The Development Of Postoperative Morbidity, Pietro Arina, John Whittle, Maciej R Kaczorek, Davide Ferrari, Nicholas Tetlow, Amy Dewar, Robert Stephens, Daniel Martin, S Ramani Moonesinghe, Evangelos B Mazomenos, Mervyn Singer

Peninsula Medical School

BACKGROUND: This study investigates the role of metabolic flexibility in determining perioperative outcomes. Metabolic flexibility, a key feature of metabolic health, is the ability to efficiently switch between different fuel sources (predominantly carbohydrates and fats) depending on energy demands and availability. Given the rapidly changing physiological conditions in the perioperative period, we hypothesized that good metabolic adaptability could mitigate postoperative complications. METHODS: We conducted a retrospective observational study utilizing a prospectively collected, single-center preoperative cardiopulmonary exercise testing (CPET) database of patients undergoing a range of major surgeries between 2012 and 2022. On day 3, patients were categorized into 3 groups …

Harnessing The Power Of Amphoterically Modified Chitosan Coagulants For Enhanced Polyester Microplastic Fibre Removal From Water, Nimesha Thathsarani, Mohadeseh Najafi, Mehdi Khiadani, Muhammad Rizwan Azhar, Masoumeh Zargar

Research outputs 2022 to 2026

Microplastic fibre (MPF) is the dominant type of microplastic present in water treatment plants’ influent. Coagulation–flocculation followed by sedimentation effectively removes microplastics during pre-treatment; however, conventional inorganic coagulants produce high sludge volume, causing secondary pollution. Chitosan offers a greener alternative but is limited by poor solubility and low molecular weight. In this study, two amphoteric modifications were successfully incorporated into Chitosan, including CMC-CTA, synthesised by modifying carboxymethyl Chitosan (CMC) with 3-chloro-2-hydroxypropyl trimethyl ammonium chloride (CTA); and CMC-g-PDMC, synthesised by grafting poly[(2-methacryloyloxyethyl) trimethyl ammonium chloride] (PDMC) onto CMC. Their coagulation performance for MPF removal was assessed by turbidity measurement. The effects …

Screening For Potential Plant Growth‐Promoting Rhizobacteria (Pgpr)-Assisted Phytoremediation To Mitigate Lead Toxicity In Uae Soils, Zeinab Mohamed Abdalla

Theses

This study investigates the potential of lead (Pb)-tolerant actinobacteria that possess 1-aminocyclopropane-1-carboxylate deaminase (ACCD) activity and plant growth-promoting (PGP) traits to serve as a biological tool for enhancing the growth of corn (Zea mays L.) under Pb stress. The primary objective of this research was to isolate and characterize novel, Pb-tolerant, rhizosphere-competent actinobacteria and to evaluate their efficacy in mitigating Pb toxicity, reducing its uptake, and promoting biomass accumulation in corn grown in contaminated soil. A total of 43 actinobacterial isolates were obtained from Pb-contaminated rhizosphere soil and screened for Pb tolerance, rhizosphere competence, ACCD activity, and PGP traits. …

Assessing Health Behaviors As Predictors Of Psychological Resilience And Bmi In A National And Small Military College Sample, Kylie Blodgett, Rachele Pojednic

Research outputs 2022 to 2026

Highlights: What are the main findings? First-year students at a military college engage in more vigorous physical activity and strength training compared to a representative national sample. In the national sample, higher levels of physical activity, strength training, and better sleep are associated with greater psychological resilience and healthier BMI values and these associations were not observed in the military college students. What are the implication of the main findings? Promoting physical activity and adequate sleep may enhance resilience and support healthy body weight in civilian college populations. Military training may overshadow the influence of individual health behaviors on resilience …

Selective Sharing And Social Bonding: A Qualitative Study Of Online Health Information Behaviour Among Older Adults In Shanghai, Minzhi Ye, Yan Liu

School of Social Work Faculty Publications

The health information landscape has been revolutionised by the advent of social media, significantly affecting older adults’ access to and interaction with online health information. In this study, we examine how older adults interact with health information on social media. In total, 30 participants aged 60 years and older from Shanghai were interviewed, focusing on their health information-seeking behaviour, perceptions, and subsequent actions using a semi-structured, in-depth interview approach. Furthermore, in this study, we employed grounded theory to analyze the data, and the results revealed that older adults utilise a comprehensive cognitive process for evaluating health information. Information-sharing decisions among …

Data As Policy, Janet Freilich, W. Nicholson Price Ii

Faculty Scholarship

A large literature on regulation highlights the many different methods of policy-making: command-and-control rulemaking, informational disclosures, tort liability, taxes, and more. But the literature overlooks a powerful method to achieve policy objectives: data. The state can provide (or suppress) data as a regulatory tool to solve policy problems. For administrations with expansive views of government’s purpose, government-provided data can serve as infrastructure for innovation and push innovation in socially desirable directions; for administrations with deregulatory ambitions, suppressing or choosing not to collect data can reduce regulatory power or serve as a back-door mechanism to subvert statutory or common law rules. …

The Link Between Mental Health And Physical Health : A Study On Seafarers In Southeast Asia, - Dewi Balqis Binti Azfar

World Maritime University Dissertations

No abstract provided.

An Assessment Of The Legal Framework For Prosecuting Iuu Fishing In Nigeria, Lydia Salla Kadiri

World Maritime University Dissertations

No abstract provided.

Precarity At Sea : Legal Challenges And Protection Of Maritime Workers, Wenjuan Li

World Maritime University Dissertations

No abstract provided.

Combating Illegal, Unreported And Unregulated (Iuu) Fishing In Argentina : Role Of Argentinian Coastguard As Maritime Authority In Charge Of Law Enforcement, Mario Damian Tiscornia

World Maritime University Dissertations

No abstract provided.

Zn Glycine Mitigates The Lps-Induced Hepatic Injury And Inflammation Through Nrf2/Nfκb Signaling In Geese, Zeshan Zulfiqar, Muhammad Arslan Asif, Layla Al-Mitib, Khawla Alharbi, Tanzina Hossain, Han Yao, Xiaoyan Zhu, Zhichang Wang, Hao Sun, Yalei Cui, Yinghua Shi

Biological Sciences Faculty Publications and Presentations

Gram-negative bacteria like Escherichia coli have an outer membrane that contains lipopolysaccharide (LPS), which is a powerful inducer of systemic inflammation. It is often associated with gut dysbiosis, intestinal barrier dysfunction, and liver damage. Despite increasing recognition of the gut-liver axis as a critical mediator in systemic inflammation and hepatic pathology, the efficacy of nutritional strategies targeting this pathway remains inadequately defined. This study evaluated the protective effects of zinc glycine (Zn_Gly), a highly bioavailable organic zinc chelate, against LPS-induced gut barrier disruption and liver damage in meat geese. Zn_Gly supplementation @ 80mg/kg of diet significantly attenuated LPS-induced impairments in …

Recycling Waste Via Insect Agriculture: Frass Impacts On Soil And Plant Health, Helen C.S. Amorim, Amanda J. Ashworth, Thomas F. Ducey, Valerie B. Brewer-Gunsaulis, Gerson L. Drescher, Philip R. Owens, Alana H. Patterson, Giovanna De Blais, Iris Van Straaten

Crop, Soil and Environmental Sciences Faculty Publications and Presentations

Frass-the main by-product of insect rearing for animal feed-is emerging as a promising soil amendment and plant growth promoter. However, basic agronomic information is lacking and prevents frass' widespread use as a biofertilizer. This study assessed impacts of black soldier fly (Hermetia illucens L. [Diptera: Stratiomyidae]) frass on soil fertility, crop growth, and quality compared to poultry litter (PL). Irrigated and non-irrigated soybean (Glycine max L. Merr.) and non-irrigated switchgrass (Panicum virgatum L.) plots received either PL (5.6 Mg ha(-1)), low frass rate (LF; 5.6 Mg ha(-1)), high frass rate (HF; 11.2 Mg ha(-1)), besides the unamended control (CT). In …

Restricting Metabolic Plasticity Enhances Stress Adaptation Through The Modulation Of Pdh And Hif1a In Trap1-Depleted Colon Cancer, Hong-Yuan Tsai, Miao-Hsueh Chen, Jihye Yun, Lisa A Lai, John F Valentine, Mary P Bronner, Teresa A Brentnall, Sheng Pan, Ru Chen

Faculty, Staff and Student Publications

Metabolic plasticity allows cancer cells to survive under adverse conditions. To investigate the role of mitochondrial chaperone tumor necrosis factor receptor-associated protein 1 (TRAP1) in this process, we used CRISPR/Cas9 mediated genetic deletion to knock out (KO) TRAP1 in colon cancer cells. Depletion of TRAP1 triggered a series of events: induced metabolic reprogramming, increased glycolytic flux, downregulation of mitochondrial complex I, and elevated ROS generation. TRAP1-deficient cells showed tolerance to Oxidative Phosphorylation (OXPHOS) inhibitors and exhibited a higher extracellular acidification rate (ECAR). Additionally, TRAP1 depletion activated hypoxia response elements (HREs) and upregulated HIF1A target genes such as GLUT1 and MCT1. …

Bicontinuous Interconnected Porous Biomaterials For Tissue Engineering And Regeneration, Aihik Banerjee, Anjana Khanal, Prince D Okoro, Shankar P Kharal, Kevin Dalsania, Baishali Kanjilal, Shiril B Iragavarapu, Yiqing Chen, Janitha M Unagolla, Huinan H Liu, Joshua T Morgan, Robert P Hesketh, Arash Pezhouman, Reza Ardehali, Bahman Anvari, Martin F Haase, Iman Noshadi

Faculty, Staff and Students Publications

Biomaterials mimicking natural extracellular matrix are necessary to create an optimal microenvironment for cell adhesion, migration, proliferation, and differentiation. These scaffolds must possess bicontinuous interconnected porosity to ensure the effective exchange of oxygen, nutrients, and metabolic waste, which are crucial for developing functional tissues. Here, a novel bicontinuous interfacially jammed emulsion (BIJEL)-Integrated PORous Engineered System (BIPORES) is developed to confer bioinert synthetic polyethylene glycol diacrylate (PEGDA) with unique bicontinuous interconnected porosity and surface topography. This platform is fabricated through controlled phase separation and interfacial stabilization of two continuous phases by nanoparticles. Functional validation using human mesenchymal stem cells, and human …

Molecular Mechanisms In Masld/Mash-Related Hcc, Xiaobo Wang, Liang Zhang, Bingning Dong

Faculty, Staff and Students Publications

Liver cancer is the third leading cause of cancer-related deaths and ranks as the sixth most prevalent cancer type globally. NAFLD or metabolic dysfunction-associated steatotic liver disease, and its more severe manifestation, NASH or metabolic dysfunction-associated steatohepatitis (MASH), pose a significant global health concern, affecting approximately 20%-25% of the population. The increased prevalence of metabolic dysfunction-associated steatotic liver disease and MASH is parallel to the increasing rates of obesity-associated metabolic diseases, including type 2 diabetes, insulin resistance, and fatty liver diseases. MASH can progress to MASH-related HCC (MASH-HCC) in about 2% of cases each year, influenced by various factors such …

Call To Action-Pediatric Masld Requires Immediate Attention To Curb Health Crisis, Phillipp Hartmann, Marialena Mouzaki, Sara Hassan, Mohit Kehar, Krupa R Mysore, Erin Mauney, Dieudonne Nonga, Sara Karjoo, Shilpa Sood, Andrea Tou, Christine Brichta, Rachel E Herdes, Nikhil Pai, Donna K Garner, Mary E Rinella, Mazen Noureddin, Zobair Younossi, Alina M Allen, Arun Sanyal, Taisa Kohut, Rohit Kohli, Charina M Ramirez, Stavra Xanthakos, Miriam B Vos, Jeffrey B Schwimmer, Samar H Ibrahim, Jennifer Panganiban

Faculty, Staff and Students Publications

Pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) has become more prevalent on a global scale over the last decades and is associated with significant comorbidities in childhood and a 40-fold higher risk of early mortality in young adulthood. MASLD has now become the leading indication for liver transplantation in young adults in the United States. However, pediatric MASLD is still perceived as an indolent condition by many patients, families, and clinicians. In this Call to Action, we aim to raise awareness of pediatric MASLD as a public health crisis. Herein, we describe insufficient screening and disease staging practices, and a …

Hospitalizations As An Outcome Measure In Courage-Als, Stacy A Rudnicki, Timothy M Miller, Et Al.

2020-Current year OA Pubs

No abstract provided.

Pharmacological Treatment For Patients With Obesity And Heart Failure: Focus On Glucagon-Like Peptide-1 Receptor Agonists. European Journal Of Heart Failure Expert Consensus Document, Luca Monzo, Gianluigi Savarese, Wilfried Mullens, Amr Abdin, Biykem Bozkurt, Ovidiu Chioncel, Seif El Hadidi, Thomas M Gorter, Riccardo M Inciardi, Mark C Petrie, Gabriele G Schiattarella, Davide Stolfo, Marco Metra, Nicolas Girerd

Faculty, Staff and Students Publications

There is growing clinical interest in strategies for improving clinical outcomes in patients with heart failure (HF) and obesity. The development of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and of the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RA has expanded therapeutic options for this population. This expert consensus provides a comprehensive and pragmatic framework for the use of GLP-1 RAs and GIP/GLP-1 RA in patients with HF, focusing on clinical integration, patient selection, safety, and tolerability. We review the evidence supporting their use in patients with HF with preserved ejection fraction (HFpEF), where clinical trials have demonstrated meaningful reductions in body …

Albuminuria As A Diagnostic Criterion And A Therapeutic Target In Heart Failure And Other Cardiovascular Disease, Biykem Bozkurt, Patrick Rossignol, Joseph A Vassalotti

Faculty, Staff and Students Publications

The high disease burden and bidirectional relationship of chronic kidney disease (CKD), heart failure (HF) and other cardiovascular disease (CVD) necessitate the need for early diagnosis of these diseases. While current screening and detection methods are recommended by CKD and CVD guidelines, their adoption in practice is low. Urine albumin-to-creatinine ratio (uACR) is recognized as a diagnostic marker for CKD and a prognostic marker for CKD progression, HF and CVD outcomes, therefore albuminuria changes have been accepted as a surrogate outcome for kidney and cardiovascular endpoints. Furthermore, clinical trials investigating guideline-directed medical therapies have shown that uACR reductions are accompanied …

Risk Score Roulette: A Cautionary Tale Of Polygenic Risk Score Reliability, Diane Xue, Elizabeth E Blue, Alexis C Wood, Jerome I Rotter, Alison E Fohner

Children’s Nutrition Research Center Staff Publications

Genetic risk prediction for Alzheimer's disease (AD) has high potential impact, yet few studies have assessed the reliability of various polygenic risk score (PRS) methods at the individual level. Here, we evaluated the reliability of AD PRS estimates among 6338 participants from the Multi-Ethnic Study of Atherosclerosis. We compared four PRS models that have been previously associated with dementia risk. Despite similar population-level performance metrics, inter-model reliability of individual-level risk assessment was low, even among individuals classified in the top and bottom deciles. These findings raise serious concerns about the downstream application of PRS for guiding interventions for AD.

A Historical Cohort Comparison After Inpatient Admission For Adolescents With Anorexia Nervosa: Feasibility Of Virtual Group Therapy, Elizabeth V Franklin, Margaret Mathias, Rachel Wolfe, Duc T Nguyen, Drusilla M Rosales, Sofia Pedroza, Albert C Hergenroeder, Constance M Wiemann

Center for Medical Ethics and Health Policy Staff Publications

Objective: Access to follow-up care after a medical admission for adolescents with anorexia nervosa (AN) is important; yet access can be delayed or unavailable. This study assessed the feasibility and acceptability of a supplemental virtual 8-week outpatient group therapy program following inpatient care. A secondary aim explored the outpatient program's impact on self-reported anxiety, disordered eating, and depression symptoms, and readmission rates.

Method: A retrospective chart review study compared 68 adolescents (aged 11-18) with AN enrolled in an 8-week group therapy program (Recovery and Prevention Program [RAPP]) to 64 adolescents who were not enrolled in RAPP (historical cohort). "RAPP completers" …

Frailty And Nutritional Status Predict Postoperative Complications In Radical Cystectomy Patients, David E Hinojosa-Gonzalez, Gal Saffati, Gustavo Salgado-Garza, Cecilio Armengol-García, Bailey Slawin, Sienna Blackwell, Jennifer M Taylor, Jeremy R Slawin

Faculty, Staff and Students Publications

Introduction: Radical cystectomy (RC) is associated with significant morbidity and mortality. While frailty and nutritional status have emerged as important predictors of surgical outcomes, their impact on RC complications remains incompletely characterized. We aimed to evaluate the relationship between frailty (using the Modified Frailty Index-5 [mFI-5], nutritional status (using the Nutritional Risk Index [NRI]), and postoperative outcomes in patients undergoing RC.

Methods: We conducted a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database. Frailty was defined as mFI-5 score ≥2 and malnutrition as NRI ≤97.5. Hypoalbuminemia was defined as preoperative albumin ≤3.5. Outcomes included …

Single-Nucleus Mrna-Sequencing Reveals Dynamics Of Lipogenic And Thermogenic Adipocyte Populations In Murine Brown Adipose Tissue In Response To Cold Exposure, Janina Behrens, Tongtong Wang, Christoph Kilian, Anna Worthmann, Mark A Herman, Joerg Heeren, Lorenz Adlung, Ludger Scheja

Faculty, Staff and Students Publications

Objective and methods: Brown adipose tissue (BAT) comprises a heterogeneous population of adipocytes and non-adipocyte cell types. To characterize these cellular subpopulations and their adaptation to cold, we performed single-nucleus mRNA-sequencing (snRNA-seq) on interscapular BAT from mice maintained at room temperature or exposed to acute (24h) or chronic (10 days) cold (6 °C). To investigate the role of the de novo lipogenesis (DNL)-regulating transcription factor carbohydrate response element-binding protein (ChREBP), we analyzed control and brown adipocyte-specific ChREBP knockout mice.

Results: We identified different cell populations, including seven brown adipocyte subtypes with distinct metabolic profiles. One of them highly expressed ChREBP …

Selective Agonism Of Liver And Gut Fxr Prevents Cholestasis And Intestinal Atrophy In Parenterally Fed Neonatal Pigs, Yanjun Jiang, Zhengfeng Fang, Gregory Guthrie, Barbara Stoll, Shaji Chacko, Sen Lin, Bolette Hartmann, Jens J Holst, Harry Dawson, Jose J Pastor, Ignacio R Ipharraguerre, Douglas G Burrin

Faculty, Staff and Students Publications

We aimed to investigate the relative efficacy of feeding different bile acids in preventing PNALD in neonatal pigs. Newborn pigs given total parenteral nutrition (TPN) combined with minimal enteral feeding of chenodeoxycholic acid (CDCA) or increasing doses of obeticholic acid (OCA) for 19 days. Enteral OCA (5 and 15 mg/kg), but not CDCA (30 mg/kg) reduced blood cholestasis markers compared to TPN controls and increased bile acids in the gallbladder and intestine. Major bile acids in the liver and distal intestine were CDCA, HCA, HDCA, and OCA, and their relative proportions were increased by the type of bile acid (CDCA …

Factors Influencing 25-Year Survival In Pediatric Liver Transplant Recipients, Garrett Wortham, Megan Crawford, John Miggins, Chun-Sing Huang, John A Goss, Abbas Rana, Nhu Thao Galván

Faculty, Staff and Students Publications

Background: This study assesses the impact of cholestatic liver disease, including biliary atresia, on 25-year survival post-transplantation and additional factors influencing long-term outcomes after pediatric liver transplantation.

Methods: We conducted a retrospective analysis of pediatric liver transplant recipients (1987-1998) using de-identified data from the OPTN 2023 Liver Database. After exclusions for multi-organ transplants (n = 222), prior transplants (n = 2256), and deaths within 1 year (n = 526), 2429 patients remained, including 645 with cholestatic disease. Univariate and multivariate analyses identified factors associated with 25-year survival.

Results: A primary diagnosis of cholestatic disease was associated with improved 25-year survival …