2021
DOI: 10.1111/petr.14069
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Operational tolerance after pediatric composite liver‐pancreas‐intestine transplantation following severe graft‐versus‐host disease

Abstract: Background While operational tolerance has been previously described in isolated intestinal transplant, reports of this phenomenon in combined liver‐intestine transplant are lacking. Case Description We detail a unique case of a patient who received a composite allograft including liver, pancreas, and small bowel due to short gut syndrome secondary to gastroschisis complicated by volvulus. The indication for transplantation was permanent dependence on total parenteral nutrition, end‐stage liver disease, recurr… Show more

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Cited by 5 publications
(7 citation statements)
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“…Table 2 summarizes the salient features and the variable path to operational tolerance in the three IT recipients from three centers. 1,2 Immunosuppression withdrawal after primary IT occurred following treatment of severe GVHD despite detectable DSA in both previous reports. In contrast, the recipient at our center achieved tolerance after a liver-inclusive multivisceral allograft, after loss of the primary intestine allograft due to refractory rejection.…”
Section: Review Of Reported Intestine Transplantation Cases With Clin...mentioning
confidence: 74%
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“…Table 2 summarizes the salient features and the variable path to operational tolerance in the three IT recipients from three centers. 1,2 Immunosuppression withdrawal after primary IT occurred following treatment of severe GVHD despite detectable DSA in both previous reports. In contrast, the recipient at our center achieved tolerance after a liver-inclusive multivisceral allograft, after loss of the primary intestine allograft due to refractory rejection.…”
Section: Review Of Reported Intestine Transplantation Cases With Clin...mentioning
confidence: 74%
“…1,9 Similarly, serologic responses to vaccine targets or EBV and CMV were also intact. 2 Interestingly, DSA, a hallmark of donor-specific humoral response were present in both previously reported tolerant IT recipients. 1,2 This finding contrasts with previous studies in operationally tolerant liver recipients in whom DSA were absent.…”
Section: Discussionmentioning
confidence: 85%
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