Evidence map›Paper›PMID 34806273›Full record

ArticlePediatric transplantation2022

Immunologic benefits of maternal living donor allografts in pediatric liver transplantation: fewer rejection episodes and no evidence of de novo allosensitization.

Arianna Barbetta, Glenda Meeberg, Brittany Rocque, Sarah Barhouma, Carly Weaver, Susan Gilmour, Farah Faytrouni, Orlee Guttman, Shannon Zielsdorf, Kambiz Etesami and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric transplantation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 2 countries.

Arianna BarbettaDepartment of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, California, USA.ORCID 0000-0001-7062-3236
Glenda MeebergAlberta Transplant Institute, Edmonton, Alberta, Canada.
Brittany RocqueDepartment of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, California, USA.
Sarah BarhoumaUniversity of Southern California, Los Angeles, California, USA.
Carly WeaverDivision of Hepatobiliary and Abdominal Organ Transplantation Surgery, Children's Hospital-Los Angeles, Los Angeles, California, USA.
Susan GilmourAlberta Transplant Institute, Edmonton, Alberta, Canada.
Farah FaytrouniDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Orlee GuttmanDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Shannon ZielsdorfDepartment of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, California, USA.
Kambiz EtesamiDepartment of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, California, USA.
Yong KwonDepartment of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, California, USA.
George YanniUniversity of Southern California, Los Angeles, California, USA.
Patricia CampbellAlberta Transplant Institute, Edmonton, Alberta, Canada.
James ShapiroAlberta Transplant Institute, Edmonton, Alberta, Canada.
Juliet EmamaulleeDepartment of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, California, USA.ORCID 0000-0003-4238-3057
University of Southern California · USNorthern Alberta Institute of Technology · CAUniversity of British Columbia · CAChildren's Hospital of Los Angeles · USUniversity of Alberta · CA

Funding

Immunologic Biomarkers of Rejection in Clinical Liver TransplantationK08CA245220 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI EMAMAULLEE, JULIET · 2020 to 2024
$1.3M
NCI NIH HHS K08 CA245220
6 · The paper itself

Abstract

backgroundPediatric liver transplant (LT) recipients of maternal living liver donor (LLD) grafts have been reported to experience fewer rejection episodes. However, it is unclear whether this benefit translates to reduction in developing donor-specific antibody (DSA) among maternal-LLD recipients. The aim of this study was to compare immunologic outcomes among maternal-LLD, non-maternal-LLD, and deceased donor liver transplant (DDLT) recipients.

methodsChildren (≤18 years) who underwent LT between 1/1998 and 12/2019 at two high-volume LT centers in North America were evaluated. Patients were divided into three groups by type of graft received (maternal-LLD, non-maternal LLD, and DDLT). Clinical variables and outcomes were compared according to each graft type.

resultsA total of 450 pediatric primary LT were analyzed: 275 (61.1%) DDLT, 73 (16.2%) maternal-LLD, and 102 (22.6%) non-maternal-LLD. Children receiving LLD grafts were less likely to develop rejection when compared to the DDLT group (DDLT 46.9% vs. maternal-LLD 31.5% vs. non-maternal-LLD 28.4%, p = 0.001). There was no difference in rejection rates between maternal and non-maternal-LLD recipients. A higher percentage of maternal-LLD recipients were on immunosuppression monotherapy compared to non-maternal-LLD and DDLT recipients (6.7% vs. 1.2 vs. 2.4%, respectively). A subgroup of 68 patients were tested for DSA post-LT. Maternal-LLD recipients were less likely to develop de novo DSA (maternal-LLD 11.8% vs. non-maternal-LLD 19.3% vs. DDLT 43%, p = 0.018). None of the maternal-LLD recipients developed antibody-mediated rejection.

conclusionsThese data support the concept of immunologic benefit of maternal-LLD in pediatric LT, with lower rates of rejection and allosensitization post-LT when compared to DDLT recipients.

Indexed as

Liver TransplantationAllograftsChildGraft RejectionGraft SurvivalHumansLiving DonorsRetrospective StudiesTransplantation, Homologousdonor specific antibodyliving donor liver transplantationmaternal liver graftmaternal tolerancepediatric liver transplantation

Identifiers

PMID34806273
PMCPMC9053650
OpenAlexW3217331760

What OpenQuestion holds

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Registered trials

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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.