MHC Class II Sharing Appears to Promote Intestinal Allograft Tolerance Through Linked Suppression in a Large Animal Model.

Background: The relative importance of major histocompatibility complex (MHC) class I and class II matching for the induction of transplantation tolerance remains unclear. We studied selective mismatches in a clinically relevant model of intestinal transplantation (ITx) in swine with defined MHC genotypes.

Methods: We performed orthotopic ITx between MHC haplotype-matched (n = 6), partially matched (having class II alleles with marked overlap, n = 2), and fully mismatched (n = 4) pairs.

Postoperative Infections and Antimicrobial Prophylaxis in the Pediatric Intensive Care Unit After Liver Transplantation in Children.

Objective: To determine the incidence and risk factors for postoperative infections (POI) after pediatric liver transplantation (LT) while in the pediatric intensive care unit (PICU).

Methods: This is a multicenter, retrospective cohort study of isolated pediatric LT recipients from 12 LT centers in the United States over 2 years. Pre- and postoperative variables were examined to determine POI risk factors during the PICU admission.

Ex Vivo Resection and Intestinal Autotransplantation: An International Multicenter Study.

Objective: To evaluate the perioperative and long-term outcomes of ex vivo resection and intestinal auto-transplantation (ERIA) for tumors.

Summary Of Background Data: ERIA could offer effective therapy for tumors considered unresectable by conventional methods. However, there has been limited data of ERIA.

Clinical utility of intraoperative wedge biopsies after preoperative core needle biopsies in biliary atresia.

Pediatric surgeons often obtain intraoperative liver wedge biopsies during Kasai portoenterostomy for biliary atresia despite an existing preoperative core needle biopsy. We conducted a single-institution retrospective review analyzing preoperative factors, Batts-Ludwig fibrosis stage (preoperative percutaneous core needle and intraoperative wedge biopsies), and survival with native liver from 2004 to 2023. Of 116 patients, 87 underwent both preoperative and intraoperative biopsies, with discordant results observed in 30/87 (34.

Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report.

Patients with hemolytic diseases are at increased risk for gallstone-related complications. Modified scoring systems have been developed to assess which pediatric patients would benefit from endoscopic retrograde cholangiopancreatography (ERCP) to treat choledocholithiasis. This study aimed to evaluate the ability of the available criteria to determine which pediatric patients with hemolytic diseases are likely to benefit from ERCP.

Determining safe washout period for immune checkpoint inhibitors prior to liver transplantation: An international retrospective cohort study.

Background And Aims: Immune checkpoint inhibitors (ICIs) are increasingly used in patients with advanced HCC patients awaiting liver transplantation (LT). However, concerns about the risk of posttransplant rejection persist.

Approach And Results: We conducted an international retrospective cohort study including 119 HCC patients who received ICIs prior to LT.

Systemic T-cell activation and IFN-γ activity in indeterminate severe hepatitis are reminiscent of hemophagocytic lymphohistiocytosis: Implications for T-cell- and IFN-γ-directed therapies.

Background: Severe hepatitis cases in children are increasingly recognized, but the exact etiology remains unknown in a significant proportion of patients. Cases of indeterminate severe hepatitis (iSH) may progress to indeterminate pediatric acute liver failure (iPALF), so understanding its immunobiology is critical to preventing disease progression. Hemophagocytic lymphohistiocytosis (HLH) is a systemic hyperinflammatory disorder associated with T-cell and macrophage activation with liver injury.

Development of a large animal orthotopic intestinal transplantation model with long-term survival for study of immunologic outcomes.

Introduction: Intestinal transplantation (ITx) is the last remaining therapy for patients with intestinal failure once parenteral nutrition is no longer an option, however its use is limited by immunological complications, including high rates of rejection and morbidity associated with immunosuppression, such as infection and malignancy. We aimed to develop a large animal model of ITx with which to study the immune response to ITx and to design and test tolerance induction regimens.

Methods: Learning from prior complications, we developed and progressively improved both surgical methods for the donor and recipient as well as postoperative management strategies.

Cell immunity to SARS-CoV-2 after natural infection and/or different vaccination regimens.

Background: The aim of the study was to evaluate the humoral and cellular immunity after SARS-CoV-2 infection and/or vaccination according to the type of vaccine, number of doses and combination of vaccines.

Methods: Volunteer subjects were sampled between September 2021 and July 2022 in Hospital Clínico San Carlos, Madrid (Spain). Participants had different immunological status against SARS-CoV-2: vaccinated and unvaccinated, with or without previous COVID-19 infection, including healthy and immunocompromised individuals.

Plasticity of intragraft alloreactive T cell clones in human gut correlates with transplant outcomes.

The site of transition between tissue-resident memory (TRM) and circulating phenotypes of T cells is unknown. We integrated clonotype, alloreactivity, and gene expression profiles of graft-repopulating recipient T cells in the intestinal mucosa at the single-cell level after human intestinal transplantation. Host-versus-graft (HvG)-reactive T cells were mainly distributed to TRM, effector T (Teff)/TRM, and T follicular helper compartments.

The diagnostic yield of exome sequencing in liver diseases from a curated gene panel.

Exome sequencing (ES) has been used in a variety of clinical settings but there are limited data on its utility for diagnosis and/or prediction of monogenic liver diseases. We developed a curated list of 502 genes for monogenic disorders associated with liver phenotypes and analyzed ES data for these genes in 758 patients with chronic liver diseases (CLD). For comparison, we examined ES data in 7856 self-declared healthy controls (HC), and 2187 patients with chronic kidney disease (CKD).

Vascular thrombosis after pediatric liver transplantation: Is prevention achievable?

Background: Vascular thromboses (VT) are life-threatening events after pediatric liver transplantation (LT). Single-center studies have identified risk factors for intra-abdominal VT, but large-scale pediatric studies are lacking.

Methods: This multicenter retrospective cohort study of isolated pediatric LT recipients assessed pre- and perioperative variables to determine VT risk factors and anticoagulation-associated bleeding complications.

Differences in the inflammatory response among hospitalized patients with distinct variants of SARS-CoV-2.

Unlabelled: The SARS-CoV-2 variants demonstrate diverse transmission patterns, modifications in infectivity, and immune response. Changes in disease manifestation may be attributed to vaccination and the virus's reduced capacity to induce inflammation.

Objectives: To investigate the relationship between the inflammatory response and the characteristics of COVID-19 across successive waves.

Endoscopic Surveillance of the Intestinal Allograft: Recommendations From the Intestinal Rehabilitation and Transplant Association Working Group.

Intestinal transplant (ITx) rejection lacks a reliable noninvasive biomarker and rejection surveillance relies on serial endoscopies and mucosal biopsies followed by histologic assessment. Endoscopic biopsies are also essential for identifying other ITx-related complications such as infectious, allergic, and inflammatory graft enteritis as well as post-transplant lymphoproliferative disease or graft versus host disease. In spite of its central role in ITx, published guidelines on endoscopy and biopsy are lacking and significant variability between centers in terms of timing and technical performance exists.

Low-Dose TMP-SMX for Pneumonia Prophylaxis in Pediatric Solid Organ Transplant Recipients.

Objective: pneumonia (PJP) is an opportunistic infection that adversely affects solid organ transplant (SOT) recipients. Published guidelines endorse 5 to 10 mg/kg/day (trimethoprim component) trimethoprim-sulfamethoxazole (TMP-SMX) as the recommended regimen for PJP prevention, often resulting in drug-related adverse effects. We investigated the use of a low-dose TMP-SMX regimen given at 2.

Genomically matched therapy in refractory colorectal cancer according to ESMO Scale for Clinical Actionability of Molecular Targets: experience of a comprehensive cancer centre network.

Efficiency of expanded genomic profiling (EGP) programmes in terms of final inclusion of patients in genomically matched therapies is still unknown. Fit patients with advanced and refractory colorectal cancer (CRC) were selected for an EGP programme. Next-generation sequencing (NGS) analysis from formalin-fixed paraffin-embedded tumour samples was performed.