This is a large single-center investigation of pediatric ABO incompatible (ABOi) liver transplants (LT) in the United States demonstrating equivalent survival outcomes following transplantation, when compared to ABO compatible LT, and without an increase in acute rejection or vascular complications. Advocacy efforts are needed in the United States to change allocation policy to expand access to ABOi LT for children on the LT waitlist.
Histopathology and MMDx displayed moderate agreement in diagnosing AR after pediatric HT, with most discrepancies in the presence of ABMR. DdcfDNA has excellent discrimination and high NPV particularly when utilizing MMDx.
Follow-up biopsies after treatment for TCMR identify a high rate of persistent rejection (55%) in pediatric kidney transplant recipients. This highlights the importance of follow-up biopsies to identify those with ongoing rejection to guide further management, as well as the need for more effective treatments for TCMR.
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