{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:22:59Z","timestamp":1787743379212,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antibody\u2010mediated rejection (AMR) in pediatric liver transplantation (LT) is uncommon and poorly understood. While human leukocyte antigen (HLA) antibodies are usually implicated in AMR, non\u2010HLA antibodies have also been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe a 7\u2010year\u2010old female with non\u2010HLA AMR in the setting of positive angiotensin type 1 receptor (AT1R) antibodies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>She was diagnosed with acute T\u2010cell mediated rejection (TCMR) 6\u2009months post\u2010LT which was treated with intravenous methylprednisolone (IVMP) but had minimal response. A repeat biopsy revealed features of AMR including C4d staining and capillaritis, but donor\u2010specific antibodies (DSAs) were negative. However, AT1R antibodies were elevated at 21\u2009U\/mL. She received antithymocyte globulin (ATG) and was started on losartan to block AT1R antibodies, with excellent response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While the recognition and mechanisms of AMR in pediatric LT are in its infancy, this case highlights the importance of considering non\u2010HLA antibodies as potential mediators of AMR. Children who fail to respond to TCMR treatment should be evaluated for AMR by obtaining DSAs, C4d staining on biopsy, and non\u2010HLA antibodies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70413","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:55:22Z","timestamp":1786971322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Angiotensin Type 1 Receptor Antibody Positivity in a Pediatric Liver Transplant Patient With Antibody\u2010Mediated Rejection: A Case Report"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4600-4732","authenticated-orcid":false,"given":"Tanya","family":"Su","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0137-0527","authenticated-orcid":false,"given":"Peter T.","family":"Jindra","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1464-3803","authenticated-orcid":false,"given":"John","family":"Hicks","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0150-4660","authenticated-orcid":false,"given":"Deborah","family":"Schady","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology Texas Children's Hospital, Baylor College of Medicine  Houston Texas 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