Evidence map›Paper›PMID 42606216›Full record

ArticlePediatric transplantation2026

Angiotensin Type 1 Receptor Antibody Positivity in a Pediatric Liver Transplant Patient With Antibody-Mediated Rejection: A Case Report.

Tanya Su, Peter T Jindra, John Hicks, Deborah Schady, Dana Cerminara, Sarah K Nicholas, John A Goss, Nhu Thao Galvan, Krupa R Mysore

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric transplantation, 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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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

9 authors.

Tanya SuDivision of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0009-0008-4600-4732
Peter T JindraDivision of Abdominal Transplantation, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-0137-0527
John HicksDepartment of Pathology and Immunology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-1464-3803
Deborah SchadyDepartment of Pathology and Immunology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-0150-4660
Dana CerminaraDivision of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-1162-6987
Sarah K NicholasDivision of Allergy and Immunology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-2163-9607
John A GossDivision of Abdominal Transplantation, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-2794-1156
Nhu Thao GalvanDivision of Abdominal Transplantation, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-1289-4692
Krupa R MysoreDivision of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0001-9890-5518

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibody-mediated rejection (AMR) in pediatric liver transplantation (LT) is uncommon and poorly understood. While human leukocyte antigen (HLA) antibodies are usually implicated in AMR, non-HLA antibodies have also been reported.

methodsWe describe a 7-year-old female with non-HLA AMR in the setting of positive angiotensin type 1 receptor (AT1R) antibodies.

resultsShe was diagnosed with acute T-cell mediated rejection (TCMR) 6 months post-LT which was treated with intravenous methylprednisolone (IVMP) but had minimal response. A repeat biopsy revealed features of AMR including C4d staining and capillaritis, but donor-specific antibodies (DSAs) were negative. However, AT1R antibodies were elevated at 21 U/mL. She received antithymocyte globulin (ATG) and was started on losartan to block AT1R antibodies, with excellent response.

conclusionWhile the recognition and mechanisms of AMR in pediatric LT are in its infancy, this case highlights the importance of considering non-HLA antibodies as potential mediators of AMR. Children who fail to respond to TCMR treatment should be evaluated for AMR by obtaining DSAs, C4d staining on biopsy, and non-HLA antibodies.

Indexed as

AntibodiesAutoantibodiesGraft RejectionLiver TransplantationReceptor, Angiotensin, Type 1BiopsyChildFemaleHumansImmunosuppressive AgentsAntibodiesAutoantibodiesImmunosuppressive AgentsReceptor, Angiotensin, Type 1allograft rejectionantibody‐mediated rejectiondonor specific antibodiesnon‐human leukocyte antigen antibodiespediatric liver transplantation

Identifiers

PMID42606216
PMCPMC13479935

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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.