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  1. Shneider BL, Gao X, Guo K, Jaramillo C, Molleston JP, Pimenta J, et al.
    Hepatology, 2026 Oct 07.
    PMID: 42842335 DOI: 10.1097/HEP.0000000000001881
    BACKGROUND AND AIMS: Management of portal hypertension in children, including primary prophylaxis of variceal bleeding, is controversial due to limited understanding of mortality risk after the first variceal hemorrhage (1VH). This international multicenter study was designed to advance understanding of outcomes after pediatric 1VH.

    APPROACH AND RESULTS: Center-specific characteristics and approaches to portal hypertension were determined at 44 international sites. K-means clustered the centers based upon volume and complexity of approaches [cluster 1 high (n=5), cluster 2 low (n=21), cluster 3 intermediate (n=18)]. Clinical features and outcomes after 1VH were available from 345 subjects. Factors associated with overall survival (OS) and survival with native liver (SNL) were estimated by Kaplan-Meier survival curves, log-rank tests, univariable and multivariable Cox regression models. OS and SNL were high in portal vein thrombosis and noncirrhotic diseases and significantly higher than biliary atresia and cirrhotic diseases ( p

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