Evidence map›Paper›PMID 41678298›Full record

SynthesisHepatology communications2026

A systematic review of post-liver transplantation treatment and outcomes for late T-cell mediated, chronic ductopenic, and antibody-mediated rejection.

Yianni Protopapadakis, Thomas D Schiano, Helen S Te, Anthony J Demetris, Paul Y Kwo, Dionisios Vrochides, Mark W Russo

Abstract readSystematic Review
In one paragraph

Synthesis in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Yianni ProtopapadakisDivision of Hepatology, Atrium Health Wake Forest, Charlotte, North Carolina, USA.
Thomas D SchianoRecanati/Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA.
Helen S TeDepartment of Gastroenterology, Hepatology, and Nutrition, Center for Liver Disease, University of Chicago Medicine, Chicago, Illinois, USA.
Anthony J DemetrisDepartment of Pathology, Division of Transplantation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Paul Y KwoDivision of Gastroenterology and Hepatology, Stanford University Medical School, Stanford, California, USA.
Dionisios VrochidesDivision of Abdominal Transplantation, Carolinas Medical Center, Atrium Health Wake Forest School of Medicine, Atrium Health, Charlotte, North Carolina, USA.
Mark W RussoDivision of Hepatology, Atrium Health Wake Forest, Charlotte, North Carolina, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCompared to the treatment for acute T-cell-mediated rejection, management of late T-cell-mediated rejection, chronic ductopenic rejection, and antibody-mediated rejection is more heterogeneous.

methodsWe conducted a systematic review of studies on the treatment of liver transplant recipients with late T-cell-mediated rejection, chronic ductopenic rejection, and antibody-mediated rejection from 2001 to 2024. Studies were included if they reported the Banff criteria for diagnosing rejection, treatment regimen(s), and response rates.

resultsTwenty studies that included a combined 374 rejection episodes were identified. Among the 20 studies, the total number of liver transplant recipients with late T-cell-mediated rejection, chronic ductopenic rejection, ABO-compatible antibody-mediated rejection, and chronic antibody-mediated rejection were 226, 67, 43, and 38, respectively. The most common regimens and response rates for late T-cell-mediated rejection, chronic ductopenic rejection, acute antibody- mediated rejection, and chronic antibody-mediated rejection were high-dose steroids and adjusting baseline immunosuppression (55%-100%), adjusting baseline immunosuppression with or without an mTOR inhibitor (25%-52%), high-dose steroids, plasma exchange or plasmapheresis and rituximab (50%-80%), and rituximab containing regimens (52%-63%), respectively. The study regimens were heterogeneous, and 7 (35%) studies were more than 10 years old.

conclusionsHigher-quality and contemporaneous data are needed to apply uniform definitions for treatment response rates and standardized treatment regimens. Regimens warranting further study include increasing baseline immunosuppression for late T-cell-mediated rejection and mTOR inhibitors for treating chronic ductopenic rejection.

Indexed as

Graft RejectionLiver TransplantationT-LymphocytesChronic DiseaseHumansImmunosuppressive AgentsTreatment OutcomeImmunosuppressive Agentsbiopsymanagementpathologyresponsetherapy

Identifiers

PMID41678298
PMCPMC13671619

What OpenQuestion holds

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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.