Maternal microchimerism in biliary atresia

Muraji, Toshihiro

doi:10.4161/chim.28576

Cited by 24 publications

(5 citation statements)

References 37 publications

(39 reference statements)

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“…Maternal lymphatic cells were found in BA infants' livers (10,11). In mixed immune reactions, cells of maternal origin could misdirect the immature immune system of the infant into bile duct autoimmunity or act directly as effectors in a graft versus host-like fashion (12,13). Lymphatic flow between liver and portal lymph nodes is bidirectional (14).…”

mentioning

confidence: 99%

Absence of Maternal Microchimerism in Regional Lymph Nodes of Children With Biliary Atresia

Engelmann

Maelzer

Kreyenberg

2016

J. pediatr. gastroenterol. nutr.

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mentioning

confidence: 99%

Absence of Maternal Microchimerism in Regional Lymph Nodes of Children With Biliary Atresia

Engelmann

Maelzer

Kreyenberg

2016

J. pediatr. gastroenterol. nutr.

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“…We chose donors with matching blood types to reduce the risk of graft loss and failure. [14][15][16][17] Biliary atresia has been the only indication for PLT at our center. This is different from the situation in other clinical centers simply because our policy limited pre-transplant diagnosis to biliary atresia during the initial phase of the program.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the living liver donors were the mothers (61.5%), and the patients and their donors had identical ABO blood types. We chose donors with matching blood types to reduce the risk of graft loss and failure 14–17 . Biliary atresia has been the only indication for PLT at our center.…”

Section: Discussionmentioning

confidence: 99%

Implementing living‐donor pediatric liver transplantation in Southern Vietnam: 15‐year results and perspectives

Tran

Luu

et al. 2023

Pediatric Transplantation

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BackgroundND2 in Ho Chi Minh City is currently the only public center that performs PLT in Southern Vietnam. In 2005, the first PLT was successfully performed, with support from Belgian experts. This study reviews the implementation of PLT at our center and evaluates the results and challenges.MethodsImplementation of PLT at ND2 required medico‐surgical team building and extensive improvement of hospital facilities. Records of 13 transplant recipients from 2005 to 2020 were studied retrospectively. Short‐ and long‐term complications, as well as the survival rates, were reported.ResultsThe mean follow‐up time was 8.3 ± 5.7 years. Surgical complications included one case of hepatic artery thrombosis that was successfully repaired, one case of colon perforation resulting in death from sepsis, and two cases of bile leak that were drained surgically. PTLD was observed in five patients, of whom three died. There were no cases of retransplantation. The 1‐year, 5‐year, and 10‐year patient survival rates were 84.6%, 69.2%, and 69.2%, respectively. There were no cases of complication or death among the donors.ConclusionLiving‐donor PLT was developed at ND2 for providing a life‐saving treatment to children with end‐stage liver disease. Early surgical complication rate was low, and the patient survival rate was satisfactory at 1 year. Long‐term survival decreased considerably due to PTLD. Future challenges include surgical autonomy and improvement of long‐term medical follow‐up with a particular emphasis on prevention and management of Epstein–Barr virus‐related disease.

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“…(22) Muraji et al subsequently identified maternal chimeric CD8 + T-cells in the livers of BA infants. (23, 24) Interestingly, Nijagal et al identified lower rates of graft failure and retransplantation in BA recipients who received maternal donor liver compared to those who received paternal donor liver, suggesting the possibility of immune tolerance secondary to exposure to non-inherited maternal antigens. (25) Muraji recently summarized findings over the past decade regarding the theory that maternal microchimerism is the underlying cause of BA wherein the initial biliary hit is due to graft-versus-host interaction by engrafted maternal effector T-lymphocytes.…”

Section: Pathogenesis Of Biliary Atresiamentioning

confidence: 99%

“…(25) Muraji recently summarized findings over the past decade regarding the theory that maternal microchimerism is the underlying cause of BA wherein the initial biliary hit is due to graft-versus-host interaction by engrafted maternal effector T-lymphocytes. (23) Ongoing analyses are essential to validate this mechanism of disease.…”

Section: Pathogenesis Of Biliary Atresiamentioning

confidence: 99%

Recent advances in the pathogenesis and management of biliary atresia

Zagory

Nguyen

Wang

2015

Current Opinion in Pediatrics

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Purpose of review The purpose of this study is to review advances in both the pathogenesis and clinical management of biliary atresia (BA). Recent Findings Immunologic studies have further characterized roles of helper T-cells, B-cells, and natural killer cells in the immune dysregulation following viral replication within and damage of biliary epithelium. PROMININ-1 expressing portal fibroblasts may play an integral role in the biliary fibrosis associated with BA. A number of genetic polymorphisms have been characterized as leading to susceptibility for BA. Postoperative corticosteroid therapy is not associated with greater transplant-free survival. Newborn screening may improve outcomes of infants with BA and may also provide a long-term cost benefit. Summary Although recent advances have enhanced our understanding of pathogenesis and clinical management, BA remains a significant challenge requiring further investigation.

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Maternal microchimerism in biliary atresia

Cited by 24 publications

References 37 publications

Absence of Maternal Microchimerism in Regional Lymph Nodes of Children With Biliary Atresia

Absence of Maternal Microchimerism in Regional Lymph Nodes of Children With Biliary Atresia

Implementing living‐donor pediatric liver transplantation in Southern Vietnam: 15‐year results and perspectives

Recent advances in the pathogenesis and management of biliary atresia

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