Correction to “Terlipressin Therapy for Portal Hyperperfusion Secondary to Portal Vein Size Discrepancy After Pediatric Liver Transplant”

Patel F., Simons J., Prasad K. R., and Lerret S. M., “Terlipressin Therapy for Portal Hyperperfusion Secondary to Portal Vein Size Discrepancy After Pediatric Liver Transplant,” Pediatric Transplantation 30, no. 3 (2026): e70285, 10.1111/petr.70285.

In the article cited above, the published version omitted a number of changes that were made at a later stage of the peer review process, as well as References 16–22. These changes have been incorporated into the published version and are summarized below for reference.

Page 2, left column

“Indications for transplantation in type I shunts include hyperammonemia, encephalopathy, or liver tumor.”

Should read

“Indications for transplantation in type I shunts include hepatic encephalopathy or liver tumors.”

“less than 1.5% graft to recipient weight ration (GRWR).”

Should read

“less than 1.5% graft to recipient weight ratio (GRWR).”[7].

“However, SFSS can occur in the presence or absence of GRWR < 0.8% [10]”

Should read

“However, SFSS can occur in the presence or absence of GRWR < 0.8% [8]”

“Octreotide, a somatostatin analog, results in vasodilation of the splanchnic vasculature and subsequently reduces portal venous pressure [10]. Additionally, terlipressin is an alternative treatment option resulting in vasodilation of the splanchnic vasculature. While terlipressin's role has been well established in the management of variceal bleeding from portal hypertension and hepatorenal syndrome in adult patients with hepatic disease, it has also been utilized in the post‐operative reduction of portal venous pressure and renal injury [13, 14]. While off label use for the management of pediatric hepatorenal syndrome has been reported, the use of terlipressin for SFSS has not been reported to date [15].”

Should read

“Octreotide, a somatostatin analog, results in vasoconstriction of the splanchnic vasculature and subsequently reduces portal venous pressure [12]. Additionally, terlipressin, a vasopressin receptor agonist, is an alternative treatment option resulting in potent vasoconstriction of the splanchnic vasculature, thereby reducing pressure within the portal vasculature [13]. While terlipressin's role has been established in management of variceal bleeding from portal hypertension, hepatorenal syndrome in adult patients with hepatic disease and catecholamine‐resistant distributive shock in pediatrics, it has also been utilized in postoperative reduction of portal venous pressure and renal injury [14–16]. While off label use for management of critically‐ill pediatric patients with hepatorenal syndrome has been reported, the use of terlipressin for SFSS has not been reported to date [17].”

Page 1, second paragraph second sentence

“This is clinically significant since intrahepatic shunts typical spontaneously close by two years of age.”

Should read

“This is clinically significant since intrahepatic shunts typically spontaneously close by two years of age.”

Page 2, right column

2.2 | Transplant Procedure

“whole graft (326 g) liver transplant at 5 years of age (patient weight 18.3 kg, native liver weight 373 g).”

Should read

“whole graft liver transplant at 5 years of age.”

Page 3, left column

“the donor portal view as the donor was half the size of the recipient. Intraoperative ultrasound confirmed velocity in the donor portal vein to be significantly higher at around 100 cm/s, due to the significant size discrepancy between the two veins.”

Should read

“the donor's portal vein as the donor portal vein was half the size of the recipient. Intraoperative ultrasound confirmed velocity in the donor portal vein to be elevated at around 100 cm/s, due to the significant size discrepancy between the two veins. On serial post‐operative ultrasound, the portal vein velocity remained unchanged at approximately 100–120 cm/s.”

3 | Post‐Operative Course

“Terlipressin was considered for treatment of suspected SFSS although was not readily available. Subsequently, octreotide was initiated as the bridge until terlipressin was available. Between POD 3 and 4, she was continued on octreotide which was titrated up to 3 μg/kg/h with mild improvement in coagulation indices and liver enzymes. She remained on octreotide until POD 6 when intravenous terlipressin became available and was initiated at a dose of 0.2 mg every 8 h. Terlipressin was ultimately discontinued on POD 10, at which point her ALT was down to 271 U/L with a normal INR.”

Should read

“Terlipressin was considered for treatment of suspected SFSS based on primary surgeon's previous experience with its use in select adult patients with SFSS following living donor transplantation [14]. However, given that it was not immediately available for use; octreotide was used as first line management. Subsequently, intravenous octreotide was initiated at 1 mcg/kg/hr as the bridge until terlipressin was available. Between POD 3 and 4, she was continued on octreotide which was titrated by 1 mcg/kg/hr up to 3 mcg/kg/hr with mild improvement in coagulation indices and liver enzymes. She remained on octreotide until POD 6 when intravenous terlipressin became available and was initiated at a dose of 0.2 mg every 8 h after discussion with the pharmacy team. Traditional dosing strategy for HRS has been reported as 0.5–1 mg every 4–6 h though a lower starting dose was chosen in this patient given limited data in the pediatric population [18]. Terlipressin was maintained at a dose of 0.2 mg and ultimately discontinued on POD 10, at which point her ALT was down to 271 U/L with a normal INR.”

Page 3, right column

4 | Discussion

“she was treated with splanchnic vasodilators”

Should read

“she was treated with splanchnic vasoconstrictors”

“portal hypertension, and elevated transaminases/coagulation indices.”

Should read

“portal hypertension, and elevations in her transaminases/coagulation indices.”

Page 4, left column

“While she did have initial improvement in labs with octreotide, liver function continued to improve to near normal with the use of terlipressin, which may be suggestive of the fact that both agents are effective in decreasing portal pressures. Another limitation to the use of terlipressin is institutional availability.”

Should read

“Although she demonstrated initial biochemical improvement with octreotide, the rate of liver enzyme normalization became more gradual. Continued improvement to near‐normal levels was observed following initiation of terlipressin, suggesting that both agents may be effective in reducing portal pressures. Octreotide was subsequently transitioned to terlipressin based on prior studies indicating that chronic administration of agonists such as octreotide may lead to receptor downregulation or desensitization, potentially resulting in diminished therapeutic efficacy over time [19–21]. Another limitation to the use of terlipressin is institutional availability. Additionally, terlipressin use may also lead to adverse side effects including abdominal pain, skin discoloration, intestinal ischemia, cardiac ischemia, cyanosis, bradycardia, and diarrhea, though this patient did not have any documented adverse effects [17, 22].”