Trial reportHepatology (Baltimore, Md.)2017
Five-year histological and serological follow-up of operationally tolerant pediatric liver transplant recipients enrolled in WISP-R.
Trial report in Hepatology (Baltimore, Md.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Immunosuppression Withdrawal for Pediatric Living-donor Liver Transplant Recipients (ITN029ST)
"Assessment of the Histological Evolution of Pediatric Patients With Liver Transplantation"
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 95 citations in OpenAlex.
- Pooled it
- IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Trial
- Prevalence and Impact of De Novo Donor-Specific Antibodies During a Multicenter Immunosuppression Withdrawal Trial in Adult Liver Transplant Recipients.Hepatology (Baltimore, Md.) · 2019Trial
- Serial Monitoring of Immune Markers Being Represented Regulatory T Cell/T Helper 17 Cell Ratio: Indicating Tolerance for Tapering Immunosuppression after Liver Transplantation.Frontiers in immunology · 2018Trial
- Induction of Clinical Operational Tolerance Through Immunosuppression Minimization: Less Is More?Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Review
- Unique 40-year survival after heart transplantation with normal graft function and spontaneous operational tolerance.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- The fate of anti-HLA antibodies following liver transplantation.Frontiers in nephrology · 2024Article
- Evidence for Alloimmune Sinusoidal Injury inTransplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Immunologic benefits of maternal living donor allografts in pediatric liver transplantation: fewer rejection episodes and no evidence of de novo allosensitization.Pediatric transplantation · 2022Article
- Clinical characteristics of immune tolerance after pediatric liver transplantation.BMC surgery · 2022Article
- Not only a small liver - The pathologist's perspective in the pediatric liver transplant setting.Pathologica · 2022Review
- Adaptation of Imaging Mass Cytometry to Explore the Single Cell Alloimmune Landscape of Liver Transplant Rejection.Frontiers in immunology · 2022Article
- Two-Dimensional Shear Wave Elastography Evaluation of Post-transplantation Complications in Pediatric Receipt: A Retrospective Cohort.Frontiers in pediatrics · 2022Article
- Chronic rejection after liver transplantation: Opening the Pandora's box.World journal of gastroenterology · 2021Article
- Advances in Liver Transplantation: where are we in the pursuit of transplantation tolerance?European journal of immunology · 2021Review
- Efficacy and Safety of Immunosuppression Withdrawal in Pediatric Liver Transplant Recipients: Moving Toward Personalized Management.Hepatology (Baltimore, Md.) · 2021Article
- Strategies for Liver Transplantation Tolerance.International journal of molecular sciences · 2021Review
- Operational tolerance in intestinal transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Non-invasive screening for subclinical liver graft injury in adults via donor-specific anti-HLA antibodies.Scientific reports · 2020Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
Pediatric liver transplant recipients arguably have the most to gain and the most to lose from discontinuing immunosuppression (IS). Whereas IS undoubtedly exerts a cumulative toll, there is concern that insufficient or no IS may contribute to allograft deterioration. Twelve pediatric recipients of parental living donor liver grafts, identified as operationally tolerant through complete IS withdrawal (WISP-R; NCT00320606), were followed for a total of 5 years (1 year of IS withdrawal and 4 years off IS) with serial liver tests and autoantibody and alloantibody assessments. Liver biopsies were performed 2 and 4 years off IS, and, at these time points, immunoglobulin G (IgG) subclass and C1q binding activity for donor-specific antibodies (DSAs) were determined. There were no cases of chronic rejection, graft loss, or death. Allografts did not exhibit progressive increase in inflammation or fibrosis. Smooth-muscle actin expression by stellate cells and CD34 expression by liver sinusoidal endothelial cells remained stable, consistent with the absence of progressive graft injury. Three subjects never exhibited DSA. However, 3 subjects showed intermittent de novo class I DSA, 4 subjects showed persistent de novo class II DSA, and 5 subjects showed persistent preexisting class II DSA. Class II DSA was predominantly against donor DQ antigens, often of high mean fluorescence intensity, rarely of the IgG3 subclass, and often capable of binding C1q.
conclusionOperationally tolerant pediatric liver transplant recipients maintain generally stable allograft histology in spite of apparently active humoral allo-immune responses. The absence of increased inflammation or progressive fibrosis suggests that a subset of liver allografts seem resistant to the chronic injury that is characteristic of antibody-mediated damage. (Hepatology 2017;65:647-660).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.