{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:44:05Z","timestamp":1768315445086,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,5,30]],"date-time":"2016-05-30T00:00:00Z","timestamp":1464566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Astellas Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chronic <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content> is associated with significant morbidity in transplant recipients. Moreover, <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content> does not prevent chronic graft failure frequently. Allograft immune tolerance in LT can be induced by complete donor chimerism through allogenic <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> combined with identical <jats:styled-content style=\"fixed-case\">LDLT<\/jats:styled-content>. This approach may exempt patients from chronic lifelong <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>. However, it is unclear whether its benefits justify its risks. Here, we present three cases from our institution and analyze seven additional reports of children treated with <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LDLT<\/jats:styled-content>, all receiving <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> due to hemato\u2010oncological indications. In eight of 10 cases, donor macrochimerism resulted in allograft tolerance. Nine patients survived. One patient died due to fulminant ADV infection. Further complications were GvHD (n\u00a0=\u00a03) and bone marrow failure (n\u00a0=\u00a02). In conclusion, donor\u2010specific allograft tolerance can be achieved by identical\u2010donor <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LDLT<\/jats:styled-content>. However, at present, this approach should generally be limited to selected indications due to a potentially unfavorable risk\u2013benefit ratio. Novel toxicity\u2010reduced conditioning protocols for <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LDLT<\/jats:styled-content> in the absence of malignant or non\u2010hepatic disease may prove to be a sufficiently safe approach for inducing graft tolerance in children receiving a <jats:styled-content style=\"fixed-case\">LDLT<\/jats:styled-content> in the future. This concept may reduce the burden of lifelong <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/petr.12725","type":"journal-article","created":{"date-parts":[[2016,5,31]],"date-time":"2016-05-31T04:06:41Z","timestamp":1464667601000},"page":"888-897","source":"Crossref","is-referenced-by-count":19,"title":["Outcomes of pediatric identical living\u2010donor liver and hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"20","author":[{"given":"Steffen","family":"Hartleif","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupert","family":"Handgretinger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Feuchtinger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred","family":"K\u00f6nigsrainer","sequence":"additional","affiliation":[{"name":"Department of Visceral\u2010 and Transplantation Surgery University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvio","family":"Nadalin","sequence":"additional","affiliation":[{"name":"Department of Visceral\u2010 and Transplantation Surgery University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekkehard","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.22422"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2010.01437.x"},{"key":"e_1_2_11_4_1","unstructured":"EuropeanLiverTransplantRegistry.Results Pediatric Transplantation 2013. 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