ArticleGastroenterology2018
Evidence of Chronic Allograft Injury in Liver Biopsies From Long-term Pediatric Recipients of Liver Transplants.
Article in Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.
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Who cites it
51 citing papers in PubMed, 154 citations in OpenAlex.
- 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
- Posttransplant biopsy risk for stable long-term pediatric liver transplant recipients: 451 percutaneous biopsies from two multicenter immunosuppression withdrawal trials.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Trial
- An Approach to Antibody-Mediated Rejection in Pediatric Liver Transplantation.Pediatric transplantation · 2026Review
- Defining the Society of Pediatric Liver Transplantation (SPLIT) research agenda: A Delphi consensus project.Hepatology communications · 2026Article
- Single-cell transcriptional landscape of liver transplant rejection reveals tissue persistence of clonally expanded, treatment-resistant T cells.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Cross-organ hierarchy of HLA molecular mismatches in donor-specific antibody development in solid organ transplantations.Cell reports. Medicine · 2025Article
- Effects ofOpen life sciences · 2025Article
- Defining the T cell transcriptional landscape in pediatric liver transplant rejection at single cell resolution.bioRxiv : the preprint server for biology · 2024Article
- Donor-derived regulatory dendritic cell infusion modulates effector CD8Science translational medicine · 2023Article
- Review
- T-cell infiltrate intensity is associated with delayed response to treatment in late acute cellular rejection in pediatric liver transplant recipients.Pediatric transplantation · 2023Article
- Hepatocyte Transplantation Rebalances Cytokines for Hepatic Regeneration in Rats with Ataxia Telangiectasia Mutated Pathway-Related Acute Liver Failure.The American journal of pathology · 2023Article
- Prospective comparison of liver stiffness measurement methods in surveillance biopsies after liver transplantation.Frontiers in transplantation · 2023Article
- Combination of everolimus and low-dose tacrolimus controls histological liver allograft injury as sufficiently as high-dose tacrolimus.Frontiers in transplantation · 2023Article
- Post-transplant donor-specific anti-HLA antibodies with a higher mean fluorescence intensity are associated with graft fibrosis in pediatric living donor liver transplantation.Frontiers in pediatrics · 2023Article
- The Role of Dynamic DNA Methylation in Liver Transplant Rejection in Children.Transplantation direct · 2022Article
- The New Challenge in Pediatric Liver Transplantation: Chronic Antibody-Mediated Rejection.Journal of clinical medicine · 2022Review
- Belatacept Treatment of Recurrent Late-onset T Cell-mediated Rejection/Antibody-mediated Rejection With De Novo Donor-specific Antibodies in a Liver Transplant Patient.Transplantation direct · 2022Article
- Risk factors associated with diabetes after liver transplant.Archives of endocrinology and metabolism · 2022Article
- A network-based approach to identify expression modules underlying rejection in pediatric liver transplantation.Cell reports. Medicine · 2022Article
Corrections and comments
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Authors and funding
26 authors at 19 institutions in 3 countries.
Funding
Abstract
BACKGROUND &
aimsA substantial proportion of pediatric liver transplant recipients develop subclinical chronic allograft injury. We studied whether there are distinct patterns of injury based on histopathologic features and identified associated immunologic profiles.
methodsWe conducted a cross-sectional study of 157 stable, long-term pediatric recipients of transplanted livers (70 boys; > 6 years old at time of transplantation; mean, 8.9 ± 3.46 years after liver transplantation) who underwent liver biopsy analysis from August 13, 2012, through May 1, 2014. Participants had received livers from a living or deceased donor and had consistently normal results from liver tests. Liver biopsy specimens were scored by a central pathologist; an unsupervised hierarchical cluster analysis of histologic features was used to sort biopsy samples into 3 clusters. We conducted transcriptional and cytometric analyses of liver tissue samples and performed a systems biology analysis that incorporated clinical, serologic, histologic, and transcriptional data.
resultsThe mean level of alanine aminotransferase in participants was 27.6 ± 14.57 U/L, and the mean level of γ-glutamyl transferase was 17.4 ± 7.93 U/L. Cluster 1 was characterized by interface activity (n = 34), cluster 2 was characterized by periportal or perivenular fibrosis without interface activity (n = 45), and cluster 3 had neither feature (n = 78). We identified a module of genes whose expression correlated with levels of alanine aminotransferase, class II donor-specific antibody, portal inflammation, interface activity, perivenular inflammation, portal and perivenular fibrosis, and cluster assignment. The module was enriched in genes that regulate T-cell-mediated rejection (TCMR) of liver and other transplanted organs. Functional pathway analysis showed overrepresentation of TCMR gene sets for cluster 1 but not clusters 2 or 3.
conclusionIn an analysis of biopsies from an apparently homogeneous group of stable, long-term pediatric liver transplant recipients with consistently normal liver test results, we found evidence of chronic graft injury (inflammation and/or fibrosis). Biopsy samples with interface activity had a gene expression pattern associated with TCMR.
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