{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T17:53:01Z","timestamp":1766339581057,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["5K12HD028827\u201028, 29"],"award-info":[{"award-number":["5K12HD028827\u201028, 29"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30 DK078392"],"award-info":[{"award-number":["P30 DK078392"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007172","name":"Cincinnati Children's Hospital Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007172","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tacrolimus (TAC)\u2010mediated renal disease occurs in up to 70% of pediatric liver transplant (LT) recipients. The safety and efficacy of renal\u2010sparing immunosuppression using anti\u2010thymocyte globulin (ATG) induction and delayed TAC administration has not been studied in children. We evaluated the safety and efficacy of ATG induction on preserving renal function in children within the first year (Y1) post\u2010LT in a single\u2010center retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children under age\u00a018\u2009years of who received isolated LT from 2008 to 2020 with a GFR\u2009&lt;\u200970 received renal\u2010sparing (RS) protocol consisting of ATG with methylprednisolone (MP), delayed TAC administration, lower initial TAC trough goals, and mycophenolate mofetil (MMF). The RS group was matched 1:2 by age and LT indication with standard immunosuppression (SI) group. Changes in renal function as well as adverse events within Y1 post\u2010LT were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010four pediatric patients were included in the analysis, of which 13 received RS. As expected, the RS group had significantly lower mean TAC trough levels at 30\u2009days (10.3 vs. 13.2, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.001) post\u2010LT. Renal function was significantly preserved at 6 (\u22120.26 vs. 0.21, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004) and 12\u2009months (\u22120.33 vs. 0.11, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.003) post\u2010LT in the RS versus SI group as measured by mean change in serum creatinine, with similar trends observed in eGFR and cystatin C. ACR, sepsis, viremia, graft loss and mortality occurred at similar rates in both RS and SI groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Induction immunosuppression with ATG and delayed TAC administration in children with renal impairment is safe and effectively preserves renal function during Y1 post\u2010LT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14509","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T07:54:59Z","timestamp":1678866899000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anti\u2010thymocyte globulin induction with delayed introduction of tacrolimus preserves renal function in pediatric liver transplant recipients"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5533-1259","authenticated-orcid":false,"given":"Michael E.","family":"Rogers","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology Hepatology and Nutrition Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Ambrosino","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Hepatology and Nutrition Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Hatcher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Hepatology and Nutrition Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Bondoc","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Tiao","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0327-1378","authenticated-orcid":false,"given":"Anna L.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Hepatology and Nutrition Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24677"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(00)70348-9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0012.2001.00013.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)15104-5"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12158"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181fa94b9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13415"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2005.09.115"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.06.014"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000185938"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13573"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-010-1149-x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13605"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","unstructured":"AsderakisA SabahTK WatkinsWJ et al.Thymoglobulin Versus Alemtuzumab Versus Basiliximab Kidney Transplantation From Donors After Circulatory Death. Kidney International Reports.2022.","DOI":"10.1016\/j.ekir.2022.01.1042"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2019.02.061"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1672621"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002974"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14509","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.14509","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14509","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T12:54:01Z","timestamp":1725627241000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.14509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/petr.14509"],"URL":"https:\/\/doi.org\/10.1111\/petr.14509","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2023,3,15]]},"assertion":[{"value":"2022-07-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14509"}}