Approaching operational tolerance in long-term pediatric liver transplant recipients receiving minimal immunosuppression

Development and Maintenance of Donor-Specific Chimerism in Semi-Allogenic and Fully Major Histocompatibility Complex Mismatched Facial Allograft Transplants

“…This observation suggested that operational tolerance may be considered in this model as the effect of the low maintenance dose of the CsA monotherapy. The same mechanism of operational tolerance was suggested by Varela-Fascinetto et al (29) in a study of liver transplant recipients maintained on low-dose CsA therapy. In addition, operational tolerance in our model was confirmed by the presence of donor-derived cells in the lymphatic tissues in both LBN and ACI recipients.…”

Severe late acute allograft rejection in a child after living‐related auxiliary partial orthotopic liver transplantation for ornithine transcarbamylase deficiency

“…Ramos et al (10) reported that weaning from immunosuppression failed in 15 (25.4%) of 59 patients. Varela-Fascinetto et al (11) also reported that 11 (27%) of 41 patients experienced hepatic dysfunction during their weaning trial of immunosuppresive regimen. However, these rejections were usually not so severe and could be easily controlled using conventional antirejection therapy, and in our previous report, we showed that our protocol for oral administration of tacrolimus in living-related liver transplantation was effective (12).…”

Withdrawal of immunosuppression in liver transplantation: Lessons learned from PTLD

“…These relatively small numbers, however, should not discourage clinicians. Many would agree that efforts to safely minimize IMS by not increasing IMS as children grow (26) are also important. Standardization of long‐term IMS regimens in pediatric LTx is greatly needed in order to better quantitate the results of this or more aggressive attempts at drug minimization.…”