{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:47:40Z","timestamp":1769161660420,"version":"3.49.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Clinical operational tolerance is the ultimate goal for liver transplantation. This study aimed to investigate the clinical characteristics of immune tolerance after pediatric liver transplantation and to identify the possible predictors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The clinical data from 37 cases of pediatric patients 2\u00a0year later after liver transplantation surgery in the Children\u2019s Hospital of Chongqing Medical University, China, were retrospectively analyzed. According to the status of the current immunosuppressant medications of the patients, they were divided into tolerance (n\u2009=\u200915) and Control (n\u2009=\u200922) groups. The current status regarding prope\/operational tolerance was reviewed and screened based on the immunosuppressant medications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The patients in the tolerance group were younger than that of Controls (p\u2009&lt;\u20090.001). The children in the tolerance group experienced no acute rejection episode and exhibited no obvious abnormalities in the liver function during the continuous follow-up period. The primary disease of the tolerance group were more often diagnosed with biliary atresia (p\u2009=\u20090.011), and received with a living donor liver graft (p\u2009=\u20090.005). There were less glomerular function, diabetes mellitus, arterial hypertension events presented in the tolerance group compared with the control group, indicating low toxicity profile.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In the current study, there were really certain quantity of recipients following liver transplantation attained long term immune tolerance, with low toxicity and satisfied liver graft function. The younger age of the recipient and maternal donor seems to promote long-term clinical immune tolerance. Further work in larger series should be required to describe the overall perspective of tolerance.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12893-021-01402-0","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T11:02:49Z","timestamp":1647687769000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical characteristics of immune tolerance after pediatric liver transplantation"],"prefix":"10.1186","volume":"22","author":[{"given":"Yan","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bailin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5121-9377","authenticated-orcid":false,"given":"Chunbao","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"issue":"1","key":"1402_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/S1499-3872(13)60002-8","volume":"12","author":"XQ Liu","year":"2013","unstructured":"Liu XQ, Hu ZQ, Pei YF, et al. Clinical operational tolerance in liver transplantation: state-of-the-art perspective and future prospects. Hepatobiliary Pancreat Dis Int. 2013;12(1):12\u201333.","journal-title":"Hepatobiliary Pancreat Dis Int"},{"issue":"4","key":"1402_CR2","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/MOT.0b013e328348b44c","volume":"16","author":"R Calne","year":"2011","unstructured":"Calne R, Watson CJ. Some observations on prope tolerance. Curr Opin Organ Transplant. 2011;16(4):353\u20138.","journal-title":"Curr Opin Organ Transplant"},{"key":"1402_CR3","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.3389\/fimmu.2020.02155","volume":"11","author":"V Ronca","year":"2020","unstructured":"Ronca V, Wootton G, Milani C, et al. The immunological basis of liver allograft rejection. Front Immunol. 2020;11:2155.","journal-title":"Front Immunol"},{"key":"1402_CR4","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.3389\/fimmu.2020.01326","volume":"11","author":"X Du","year":"2020","unstructured":"Du X, Chang S, Guo W, et al. Progress in liver transplant tolerance and tolerance-inducing cellular therapies. Front Immunol. 2020;11:1326.","journal-title":"Front Immunol"},{"issue":"8","key":"1402_CR5","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1111\/petr.12795","volume":"20","author":"AH Lau","year":"2016","unstructured":"Lau AH, Vitalone MJ, Haas K, et al. Mass cytometry reveals a distinct immunoprofile of operational tolerance in pediatric liver transplantation. Pediatr Transplant. 2016;20(8):1072\u201380.","journal-title":"Pediatr Transplant"},{"issue":"2","key":"1402_CR6","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.trim.2006.10.004","volume":"17","author":"T Koshiba","year":"2007","unstructured":"Koshiba T, Li Y, Takemura M, et al. Clinical, immunological, and pathological aspects of operational tolerance after pediatric living-donor liver transplantation. Transpl Immunol. 2007;17(2):94\u20137.","journal-title":"Transpl Immunol"},{"issue":"2","key":"1402_CR7","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1002\/hep.28681","volume":"65","author":"S Feng","year":"2017","unstructured":"Feng S, Demetris AJ, Spain KM, et al. Five-year histological and serological follow-up of operationally tolerant pediatric liver transplant recipients enrolled in WISP-R. Hepatology. 2017;65(2):647\u201360.","journal-title":"Hepatology"},{"issue":"6","key":"1402_CR8","doi-asserted-by":"publisher","first-page":"784","DOI":"10.3349\/ymj.2009.50.6.784","volume":"50","author":"JH Lee","year":"2009","unstructured":"Lee JH, Lee SK, Lee HJ, et al. Withdrawal of immunosuppression in pediatric liver transplant recipients in Korea. Yonsei Med J. 2009;50(6):784\u20138.","journal-title":"Yonsei Med J"},{"issue":"7","key":"1402_CR9","doi-asserted-by":"publisher","first-page":"e13560","DOI":"10.1111\/petr.13560","volume":"23","author":"MH Kim","year":"2019","unstructured":"Kim MH, Akbari O, Genyk Y, et al. Immunologic benefit of maternal donors in pediatric living donor liver transplantation. Pediatr Transplant. 2019;23(7):e13560.","journal-title":"Pediatr Transplant"},{"issue":"12","key":"1402_CR10","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1002\/lt.24845","volume":"23","author":"S Feng","year":"2017","unstructured":"Feng S, Bucuvalas J. Tolerance after liver transplantation: where are we? Liver Transpl. 2017;23(12):1601\u201314.","journal-title":"Liver Transpl"},{"key":"1402_CR11","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.3389\/fimmu.2020.01615","volume":"11","author":"N Tanimine","year":"2020","unstructured":"Tanimine N, Ohira M, Tahara H, et al. Strategies for deliberate induction of immune tolerance in liver transplantation: from preclinical models to clinical application. Front Immunol. 2020;11:1615.","journal-title":"Front Immunol"},{"key":"1402_CR12","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.3389\/fimmu.2020.01203","volume":"11","author":"Y Jiang","year":"2020","unstructured":"Jiang Y, Que W, Zhu P, et al. The role of diverse liver cells in liver transplantation tolerance. Front Immunol. 2020;11:1203.","journal-title":"Front Immunol"},{"issue":"6","key":"1402_CR13","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1097\/TP.0000000000002110","volume":"102","author":"EM Przybyszewski","year":"2018","unstructured":"Przybyszewski EM, Verna EC, Lobritto SJ, et al. Durable clinical and immunologic advantage of living donor liver transplantation in children. Transplantation. 2018;102(6):953\u201360.","journal-title":"Transplantation"},{"issue":"2","key":"1402_CR14","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1002\/hep.28459","volume":"64","author":"S Todo","year":"2016","unstructured":"Todo S, Yamashita K, Goto R, et al. A pilot study of operational tolerance with a regulatory T-cell-based cell therapy in living donor liver transplantation. Hepatology. 2016;64(2):632\u201343.","journal-title":"Hepatology"},{"issue":"10","key":"1402_CR15","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1002\/lt.23481","volume":"18","author":"Banff Working Group on Liver Allograft Pathology","year":"2012","unstructured":"Banff Working Group on Liver Allograft Pathology. Importance of liver biopsy findings in immunosuppression management: biopsy monitoring and working criteria for patients with operational tolerance. Liver Transpl. 2012;18(10):1154\u201370.","journal-title":"Liver Transpl"},{"issue":"3","key":"1402_CR16","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1097\/00007890-200108150-00016","volume":"72","author":"M Takatsuki","year":"2001","unstructured":"Takatsuki M, Uemoto S, Inomata Y, et al. Weaning of immunosuppression in living donor liver transplant recipients. Transplantation. 2001;72(3):449\u201354.","journal-title":"Transplantation"},{"issue":"5","key":"1402_CR17","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1002\/hep.31520","volume":"73","author":"S Feng","year":"2021","unstructured":"Feng S, Bucuvalas JC, Mazariegos GV, et al. Efficacy and safety of immunosuppression withdrawal in pediatric liver transplant recipients: moving toward personalized management. Hepatology. 2021;73(5):1985\u20132004.","journal-title":"Hepatology"},{"issue":"11","key":"1402_CR18","doi-asserted-by":"publisher","first-page":"3570","DOI":"10.3390\/jcm9113570","volume":"9","author":"K Herzer","year":"2020","unstructured":"Herzer K, Sterneck M, Welker MW, et al. Current challenges in the post-transplant care of liver transplant recipients in Germany. J Clin Med. 2020;9(11):3570.","journal-title":"J Clin Med"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-021-01402-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-021-01402-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-021-01402-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T11:04:52Z","timestamp":1647687892000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/s12893-021-01402-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,19]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1402"],"URL":"https:\/\/doi.org\/10.1186\/s12893-021-01402-0","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,19]]},"assertion":[{"value":"18 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Expedited approval by The Ethics Committee of Chongqing Medical University. All participants understood the nature of the research project and the parents or guardians of the study participants gave written consent for their respective children to participate in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No potential conflicts of interest relevant to this article are reported.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"102"}}