Pediatric Transplantation最新文献

{"title":"Angiotensin Type 1 Receptor Antibody Positivity in a Pediatric Liver Transplant Patient With Antibody-Mediated Rejection: A Case Report.","authors":"Tanya Su, Peter T Jindra, John Hicks, Deborah Schady, Dana Cerminara, Sarah K Nicholas, John A Goss, Nhu Thao Galvan, Krupa R Mysore","doi":"10.1111/petr.70413","DOIUrl":"10.1111/petr.70413","url":null,"abstract":"<p><strong>Background: </strong>Antibody-mediated rejection (AMR) in pediatric liver transplantation (LT) is uncommon and poorly understood. While human leukocyte antigen (HLA) antibodies are usually implicated in AMR, non-HLA antibodies have also been reported.</p><p><strong>Methods: </strong>We describe a 7-year-old female with non-HLA AMR in the setting of positive angiotensin type 1 receptor (AT1R) antibodies.</p><p><strong>Results: </strong>She was diagnosed with acute T-cell mediated rejection (TCMR) 6 months post-LT 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-specific antibodies (DSAs) were negative. However, AT1R antibodies were elevated at 21 U/mL. She received antithymocyte globulin (ATG) and was started on losartan to block AT1R antibodies, with excellent response.</p><p><strong>Conclusion: </strong>While the recognition and mechanisms of AMR in pediatric LT are in its infancy, this case highlights the importance of considering non-HLA 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-HLA antibodies.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70413"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Syndrome and Cardiovascular Outcomes in Pediatric Kidney Transplant Recipients-A Cross-Sectional Study.","authors":"Anshuman Saha, Bhavik Champaneri, Vaidehi Patel, Harda Shah, Shahenaz Kapadia, Kinnari Vala, Disha Bhatt, Himanshu Patel, Dinesh Gera, Manisha Modi, Pranjal Modi","doi":"10.1111/petr.70438","DOIUrl":"10.1111/petr.70438","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to determine the prevalence of obesity and metabolic syndrome (MS) and analyze the cardiovascular outcomes in pediatric kidney transplant recipients from a single center in India.</p><p><strong>Methods: </strong>Determinants of MS, including weight, height, body mass index (BMI), blood pressure, fasting blood sugar, triglyceride, and high-density lipoprotein (HDL) were collected for children with at least 1 year follow-up post-transplant. Cardiovascular outcomes were hypertension, left ventricular hypertrophy (LVH), and carotid intima medial thickness (cIMT). Muscle strength was evaluated by measuring hand grip strength (HGS). Diagnosis of obesity and MS was done by applying recommendations from the Pediatric Renal Nutrition Task Force.</p><p><strong>Results: </strong>The median age of the cohort (32 recipients, 71% male) was 14.0 years (IQR 12.0, 15.9). At a median 21.5 months (IQR 17, 37.5) after first kidney transplantation, 9 (28.1%) had MS. Hypertriglyceridemia was present in 17 children (53.1%), low HDL cholesterol in 10 (31.2%), hypertension in 22 (68.8%), and fasting hyperglycemia in 7 (21.9%). The ΔBMI height-age Z-score was significantly higher in the MS group (p = 0.003). There was no difference in eGFR, LVMI, Triglyceride index and HGS between the MS and Non-MS groups. In multivariate regression analysis, the ΔBMI height-age Z-score and Acute rejection were independent predictors of MS and LVH, respectively. MS was not an independent predictor of LVH. All patients had elevated cIMT.</p><p><strong>Conclusion: </strong>MS was found in about a third of the cohort. Graft function and LVH were similar between the groups. Post-transplant weight gain was a key determinant of MS.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70438"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance Use Patterns in Pediatric Solid Organ Transplant Candidates: Impact After Transplant.","authors":"Daniel Thomson, Anna Dammann, Eric Benz, Eliza Blanchette, Margret Bock, Elizabeth S Christofferson","doi":"10.1111/petr.70427","DOIUrl":"10.1111/petr.70427","url":null,"abstract":"<p><strong>Background: </strong>The prevalence and impact of substance use in pediatric solid organ transplant candidates and how these relate to post-transplant outcomes are not well studied.</p><p><strong>Methods: </strong>The Alcohol and Substance Use modules of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) were administered to all patients aged 12-18 who underwent heart, liver, or kidney transplant evaluation at our institution between 6/2020 and 12/2023. A total of 55 patients underwent KSADS testing at evaluation, received a transplant, and had adequate follow-up for inclusion. Following transplant, outcome measures included time-weighted coefficient of variance (TW-CoV) in serum tacrolimus level and organ rejection during follow-up.</p><p><strong>Results: </strong>A total of 9 patients (16%) endorsed ever trying any substance at time of pre-transplant evaluation. Past and present substance use impairment symptoms based on DSM-5 substance use impairment criteria pre-transplant were significantly associated with TW-CoV (past: r = 0.37, p = 0.006; present: r = 0.39, p = 0.003) in tacrolimus levels post-transplant. Past substance use impairment symptoms pre-transplant were associated with organ rejection by 1 year post-transplant (r = 0.32, p = 0.034). For patients who endorsed ever trying any substance, or trying any substance 5+ times, there were no significant differences for either group in adherence or rejection episodes when compared to patients who reported never trying any substance.</p><p><strong>Conclusion: </strong>Rates of substance use are relatively low in this population of pediatric solid organ transplant candidates. Substance use impairment symptoms identified pre-transplant are associated with increased rejection episodes and surrogate markers for non-adherence post-transplant.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70427"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living Donor Liver Transplantation as Salvage Therapy for Steroid-Refractory Chronic Hepatic GVHD Following Allogeneic Hematopoietic Stem Cell Transplantation.","authors":"Urvi Kapoor, Steven J Lobritto, Monica Bhatia","doi":"10.1111/petr.70415","DOIUrl":"10.1111/petr.70415","url":null,"abstract":"<p><strong>Background: </strong>Hepatic graft-versus-host disease (GVHD) is a rare but life-threatening complication following allogeneic hematopoietic stem cell transplantation (HSCT). Steroid-refractory hepatic GVHD carries a high risk of mortality with limited salvage options. Liver transplantation after HSCT poses unique challenges due to dual alloimmunity and is rarely pursued, particularly in pediatric patients. We report a pediatric patient with steroid-refractory chronic hepatic GVHD successfully treated with living donor liver transplantation (LDLT) from a parental donor.</p><p><strong>Case presentation: </strong>A 13-year-old male underwent allogeneic HSCT for idiopathic severe aplastic anemia and developed progressive chronic hepatic GVHD characterized by ductopenia and severe cholestasis. His disease was refractory to corticosteroids and multiple additional therapies, including ruxolitinib, mesenchymal stromal cells, infliximab, sirolimus, anti-thymocyte globulin, alpha-1 antitrypsin, cyclophosphamide, and emapalumab. His course was complicated by Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorder (PTLD), successfully treated with rituximab. Fifteen months after HSCT, and seven months after clearance of EBV viremia, he underwent LDLT from a parental donor. Donor selection preserved the option for future donor-derived EBV-specific cytotoxic T lymphocyte therapy if needed. Eleven months following LDLT, the patient remains clinically well, with normal liver function, sustained full donor chimerism, and no evidence of recurrent GVHD or PTLD.</p><p><strong>Conclusion: </strong>LDLT may represent a viable option in select pediatric patients with irreversible chronic hepatic GVHD. This case underscores the importance of early multidisciplinary planning and highlights the absence of liver-specific biomarkers or targeted therapies to guide management. Dedicated research into preventive and regenerative strategies is warranted.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70415"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor-Derived Cell-Free DNA in Stable Pediatric Kidney Transplant Recipients: Influence of Donor Obesity and Recipient Size.","authors":"Julia Steinke, Lyndsay Harshman, Kelly Kirshner, Arundhati Kale, Erica Winnicki, Daniel Ranch, Jayanthi Chandar, Helen Pizzo, Arshdeep Kaur, Paul Hanson, Zunqiu Chen, Ling Shen, Dechu Puliyanda","doi":"10.1111/petr.70416","DOIUrl":"10.1111/petr.70416","url":null,"abstract":"<p><strong>Background: </strong>Donor-derived cell-free DNA (dd-cfDNA) is increasingly used as a noninvasive marker of kidney allograft injury, but adult-derived cutoffs may not be applicable to pediatric recipients, particularly in the setting of donor-recipient size mismatch. We evaluated dd-cfDNA levels in stable pediatric kidney transplant (KT) recipients and assessed variation by recipient weight and donor body mass index (BMI).</p><p><strong>Methods: </strong>Retrospective data were collected from seven U.S. pediatric KT centers. Clinically stable recipients < 18 years of age (no de novo donor specific antibody, biopsy-proven rejection or BK viremia/nephropathy), with ≥ 2 dd-cfDNA measurements per year were included. Recipients were stratified by weight at dd-cfDNA collection (< 20 kg, 20-50 kg, > 50 kg). Donor BMI was categorized as underweight (≤ 18.5), normal (18.6-24.9), overweight (25-29.9), or obese (≥ 30). Comparisons were performed using linear mixed-effects models.</p><p><strong>Results: </strong>Among 178 recipients, mean dd-cfDNA did not differ by recipient weight (< 20 kg: 0.51 ± 0.44; 20-50 kg: 0.65 ± 1.28; > 50 kg: 0.49 ± 0.70). Median dd-cfDNA was similar across donor BMI categories. However, among obese donors, recipients < 20 kg had 1.3-fold higher dd-cfDNA (p = 0.044). Donor-recipient body surface area mismatch > 1.5 was associated with 1.083-fold higher dd-cfDNA up to 5 years post-transplant (p = 0.016).</p><p><strong>Conclusions: </strong>In stable pediatric KT recipients, dd-cfDNA levels were well below the adult-derived 1% cutoff, reinforcing the generalizability of this cutoff to the pediatric population. Recipients < 20 kg with donor BMI > 30 kg/m² or in the setting of a donor-recipient BSA mismatch > 1.5 were associated with higher dd-cfDNA levels.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70416"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Liver-Kidney Transplantation in Pediatric Patients From Colombia: A Case Series.","authors":"Alejandro Padilla-Guzmán, Sergio A Ortega-Gamboa, Jessica María Forero-Delgadillo, Vanessa Amparo Ochoa-Jiménez, Ana M Portilla-Buenaventura, Camilo José Cuadros Mateus, Verónica Botero-Osorio, Harry Pachajoa, Jaime M Restrepo","doi":"10.1111/petr.70419","DOIUrl":"10.1111/petr.70419","url":null,"abstract":"<p><strong>Background: </strong>Pediatric combined liver-kidney transplantation is uncommon, and evidence from Latin America is scarce.</p><p><strong>Methods: </strong>We report a single-center case series of four pediatric recipients who underwent combined liver-kidney transplantation at a tertiary Latin-American center. We summarize primary indications, perioperative course, early complications, and graft function at follow-up.</p><p><strong>Results: </strong>Underlying diseases were primary hyperoxaluria type I (n = 1), nephronophthisis type 3 (n = 2), and hepatorenal fibropolycystic disease/autosomal recessive polycystic kidney disease (n = 1). Early complications included bacterial and viral infections, bleeding, and acute tubular necrosis. Three biopsy-proven acute rejection episodes occurred (one moderate-severe hepatic and two renal, including one late T-cell-mediated episode); all responded to treatment. At last follow-up, all four patients were alive with functioning liver and kidney grafts. In three cases with long-term follow-up, the estimated glomerular filtration rate was 72, 64, and 48 mL/min/1.73 m² with normal liver profiles; in one case with shorter institutional follow-up, the estimated glomerular filtration rate was 74 mL/min/1.73 m² with a transient liver profile abnormality.</p><p><strong>Conclusions: </strong>This first pediatric series from Latin America suggests that combined liver-kidney transplantation is feasible and can achieve favorable long-term patient and graft survival when candidates are appropriately selected and infectious and rejection complications are managed in a protocolized manner.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70419"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survivorship Bias in the Shadows: A Methodological Concern Regarding Post-Transplant Survival Analysis in Pediatric VAD Recipients.","authors":"Saad Ishtiaq, Zain Mehboob Malik, Abdur Rahim Ahmad","doi":"10.1111/petr.70385","DOIUrl":"10.1111/petr.70385","url":null,"abstract":"","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70385"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-Low Weight < 5 Versus 5-9.9-kg Pediatric Liver Transplant Recipients: Characteristics and Intraoperative Vasopressor Comparisons.","authors":"Lori A Aronson, Kim My Li, Alexander J Bondoc, Stephen Hartman, Alyssa Stetson, Cheryl Hartzell, Nicolas Noriega, Lili Ding, Jiwon Lee","doi":"10.1111/petr.70420","DOIUrl":"10.1111/petr.70420","url":null,"abstract":"<p><strong>Background: </strong>Survival in pediatric liver transplantation (PLT) has significantly improved in infants under 1 year, but < 10 kg and < 6 months continue to have poor outcomes with a paucity of information on ultra-low weight (ULW) infants (< 5 kg). We compared intraoperative vasopressor use in < 5 kg versus 5-< 9.9 kg PLT recipients.</p><p><strong>Methods: </strong>We conducted a single-center retrospective review of all PLT recipients < 10 kg at time of transplant from 2009 to 2022, excluding multi-organ transplantation. We collected data on demographics, diagnosis, intraoperative vasoactive infusions, blood loss and requirements, and abdominal closure timing. Outcomes data include total mechanical ventilation, intensive care and hospital length of stay days, 1-year patient and graft survival and thrombotic complications.</p><p><strong>Results: </strong>ULW < 5 kg and 5-9.9 kg patients showed average weight of 4.53 versus 7.30 kg (p-value < 0.0001) and average age of transplant 3.36 versus 7.90 months (p-value 0.0002). The most common etiology of liver disease for ULW versus 5-9.9 kg was neonatal acute liver failure (3 of 5) versus biliary atresia (41 of 63). No significant difference in anhepatic time, abdominal closure, blood products transfused/kg, estimated blood loss/kg was noted. Total days of mechanical ventilation, ICU and hospital LOS were similar between groups. ULW trends toward higher doses of vasopressors during PLT, most notably at end of case compared to 5-9.9 kg (p = 0.06). Overall, 1-year graft and patient survival were 91% and 94%, respectively. HAT and PVT did not appear to be associated with VIS by phase of surgery, but PVT occurred relatively more in the < 5 kg group (2 vs. 4) and HAT in the 5-9.9 kg group (0 vs. 3).</p><p><strong>Conclusions: </strong>Results show etiology of liver failure differs and < 5 kg trends to an increased amount of vasopressor use, especially at end of case, suggesting more hemodynamic instability requiring support; however, this did not correlate with measured hospital metrics. Split graft PLT recipients have more blood loss and require more transfusions. PVT was observed more in the < 5 kg cohort. Etiology, not just size or early age, may contribute to the higher and sustained pressor requirements and possible PVT risk in ULW infants.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70420"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: \"Optimizing Longitudinal Psychosocial Support in Pediatric Heart Transplant Recipients and Their Families\".","authors":"Leandra Bitterfeld, Kelly Mansfield, Lindsay J May","doi":"10.1111/petr.70435","DOIUrl":"https://doi.org/10.1111/petr.70435","url":null,"abstract":"","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70435"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TCR-αβ/CD 19 Depleted Graft Versus T Replete Graft With Post-Transplant Cyclophosphamide in Children Undergoing Haploidentical Donor Hematopoietic Stem Cell Transplantation for Inborn Errors of Immunity: A Comparative Analysis From India.","authors":"Anuraag Reddy Nalla, Kavitha Ganesan, Vijayshree Muthukumar, Minakshi Balwani, Nithya Seshadri, Krithika Krishnakumar, Ramya Uppuluri, Revathi Raj","doi":"10.1111/petr.70436","DOIUrl":"10.1111/petr.70436","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to analyze the outcomes of TCRαβ/CD19-depleted and T-replete graft with post-transplant cyclophosphamide (PTCY) in haploidentical hematopoietic stem cell transplantation (HSCT) in inborn errors of immunity (IEI).</p><p><strong>Patients and methods: </strong>We performed a retrospective analysis of children from birth to 18 years of age with IEI who underwent haploidentical HSCT between April 2009 and September 2024, with a minimum follow-up period of 12 months.</p><p><strong>Results: </strong>A total of 230 children with IEI underwent HSCT in the 15-year period, where 105 (45%) underwent haploidentical HSCT and were included in the analysis with a follow up period of 0.5 to 170 months. TCR-αβ/CD19-depleted HSCT was done in 65 (62%) children, while T-replete graft with PTCY was used in 40 (38%) children. There was no significant difference in engraftment rates, acute and chronic graft versus host disease rates between both the cohorts: T-depleted group-89%, 8.6%, 12% respectively versus T-replete group-85%, 15%, 17.5% respectively. The 5-year overall survival was 62% (95% CI: 48%-73%) in the TCR-αβ/CD 19-depleted cohort in comparison to 54% (95% CI: 48% to 73%) in the PTCY cohort. When the survival was compared in children less than 2 years of age, it was 60% in the TCR-αβ/CD 19 depleted cohort versus 37% in PTCY cohort (p value of 0.001).</p><p><strong>Conclusion: </strong>Survival was superior in the T depleted cohort as compared to the T replete group, with viral reactivation remaining a persisting challenge. Letermovir prophylaxis and memory cell add-back would be potential strategies to improve survival.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"30 8","pages":"e70436"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}