{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:51:56Z","timestamp":1788911516648,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Following pediatric liver transplantation (pLT), the significance and management of donor\u2010specific antibodies (DSA) against human leukocyte antigen (HLA) remain undefined. The aim of this single\u2010center study was to investigate the occurrence of DSA, their clinical impact on predictors for and protectors against DSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      We compared anti\u2010HLA DSA (cutoff for mean fluorescence intensity (MFI)\u00a0\u2265\u00a01000), clinical and laboratory results and outcome in a routine (RG,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0142, standard DSA testing) and a hepatopathy group (HG,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a019, DSA testing following indeterminate hepatopathy) in 161 pLT patients, treated 2000\u20132021, retrospectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      40% of RG and 32% of HG patients were DSA+ (39% of all patients, of which 13% with antibody\u2010mediated rejection [AMR]). Most frequent DSA subtypes were HLA\u2010DQ3, \u2010DQ1, \u2010DQ2 in RG and HLA\u2010DQ2, \u2010DR15 in HG. MFI was higher for anti\u2010HLA II DSA (15\u00a0257 DSA+ vs. 5500 DSA\u2212,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.003), especially with AMR (21\u00a0000 DSA+ with AMR vs. 14\u00a0584 DSA+ without AMR,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.042). Predictors for DSA included age at pLT, re\u2010pLT, and cystic fibrosis. Living donation and cold ischemia time &lt;8\u00a0h appeared to offer protection. Graft survival was poorer with DSA (RG 78% DSA+ vs. 97% DSA\u2212,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.018, HG 67% DSA+ vs. 100% DSA\u2212,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.0007). Patient survival was 97% for the entire cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DSA were detectable in 39% and associated with AMR in 13% of children post\u2010pLT in addition to worse graft survival in all patients. Patient survival of 97% was not influenced. Potential DSA and predictors and protectors were identified. Therefore, DSA diagnostics are recommended after pLT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70390","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T15:04:55Z","timestamp":1763737495000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of Donor\u2010Specific Human Leukocyte Antigen Antibodies Following Pediatric Liver Transplantation: Predictors, Protectors, and Clinical Relevance"],"prefix":"10.1111","volume":"39","author":[{"given":"Evelien","family":"Kanaan","sequence":"first","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinja","family":"Ohlsson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Kathemann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benas","family":"Prusinskas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Tsaka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falko M.","family":"Heinemann","sequence":"additional","affiliation":[{"name":"Institute for Transfusion Medicine Transplantation Diagnostic, University Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Heinold","sequence":"additional","affiliation":[{"name":"Institute for Transfusion Medicine Transplantation Diagnostic, University Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Schulze","sequence":"additional","affiliation":[{"name":"Department of General Visceral\u2010 and Transplant Surgery University Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Pape","sequence":"additional","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7624-2968","authenticated-orcid":false,"given":"Elke","family":"Lainka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics II University Children's Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000450"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2016.05.040"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23534"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/eji.202048875"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000275"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31520"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13909"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.10.059"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13749"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.02155"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001598"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23788"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23948"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00292-020-00813-9"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.07.125"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000228834"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2007.02.007"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000625"},{"issue":"5","key":"e_1_2_12_20_1","first-page":"1383","article-title":"Liver Allograft Rejection in Sensitized Recipients. 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