{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T01:42:40Z","timestamp":1773366160224,"version":"3.50.1"},"reference-count":27,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"Sp. 2","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["Biomed."],"abstract":"<jats:p>Introduction. Graft-versus-host disease is a serious complication after hematopoietic stem cell transplantation and is a major cause of death post-transplantation. Approximately 50% of acute graft-versus-host disease patients do not respond to systemic steroids and their prognosis is poor regardless of the treatment. This study describes our experience with pediatric patients diagnosed with steroid-refractory graft-versus-host disease who received intra-mesenteric steroid treatment.Objective. To determine the outcomes of intra-mesenteric steroid use in the management of pediatric patients diagnosed with refractory graft-versus-host disease.Materials and methods. The study included patients under 18 years old with allogeneic hematopoietic stem cell transplantation who underwent intra-mesenteric steroid injection for resistant gastrointestinal graft-versus-host disease between January, 2016, and December, 2021. Methylprednisolone was administered via intra-arterial injection through the celiac trunk and the superior and inferior mesenteric arteries.Results. We collected data on 21 patients: nine (90%) responded with a subjective decrease in fecal output and a reduction in bilirubin and transaminases. Seven patients required a second intra-mesenteric injection and presented a complete response in 85% of the cases. Only one patient experienced local complications after the procedure. Twelve patients (57%) died with one death due to acute graft-versus-host disease. Conclusion. Reports in the adult population have shown an approximately 50% response rate with few complications, making it a second-line management standard. As far as we know, this is the largest pediatric cohort reported in Latin America. Our findings suggest that intra-mesenteric steroid administration for managing hepatic and gastrointestinal graftversus-host disease may be considered an early adjuvant treatment in patients with steroidrefractory graft-versus-host disease.<\/jats:p>","DOI":"10.7705\/biomedica.7394","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T15:50:52Z","timestamp":1736437852000},"page":"63-71","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Intra-mesenteric steroids for steroid-refractory graft-versus-host disease in pediatric patients: A safe option","Esteroides intramesent\u00e9ricos para la enfermedad de injerto contra hu\u00e9sped resistente a esteroides en pacientes pedi\u00e1tricos: una opci\u00f3n segura"],"prefix":"10.7705","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2234-5152","authenticated-orcid":false,"given":"Ana M.","family":"Aristiz\u00e1bal","sequence":"first","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia"},{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0723-8842","authenticated-orcid":false,"given":"Lina P.","family":"Monta\u00f1a","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia"},{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0550-0923","authenticated-orcid":false,"given":"Jaiber","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia"},{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1465-7957","authenticated-orcid":false,"given":"Diego","family":"Medina","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Unidad de Trasplante de M\u00e9dula \u00d3sea, Servicio de Hematoncolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia"},{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Unidad de Trasplante de M\u00e9dula \u00d3sea, Servicio de Hematoncolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3173-6059","authenticated-orcid":false,"given":"Alexis A.","family":"Franco","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Unidad de Trasplante de M\u00e9dula \u00d3sea, Servicio de Hematoncolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia"},{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Unidad de Trasplante de M\u00e9dula \u00d3sea, Servicio de Hematoncolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5577-970X","authenticated-orcid":false,"given":"Eliana","family":"Manzi","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili, Cali, Colombia"},{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1845-9082","authenticated-orcid":false,"given":"\u00c1ngela Devia","family":"Zapata","sequence":"additional","affiliation":[{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili, Cali, Colombia"},{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4010-2103","authenticated-orcid":false,"given":"Walter","family":"Mosquera","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno-Infantil, Fundaci\u00f3n Valle del Lili, Cali, Colombia; 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