JPGN Journal Club May 2023: Protocol Biopsies in Pediatric Liver Transplant and Trough-Level–Guided IBD Therapy

Today we are talking to Dr. Andreas Jenke — Journal Club again! Two articles of particular interest and significance from the May, 2023, number of JPGN are discussed. From Eva Karbaum and colleagues in Hamburg (Protocol Biopsies in Pediatric Liver Transplantation Recipients Improve Graft Histology and Personalize Immunosuppression) we learn that using protocol-biopsy findings to fine-tune liver transplant recipients’ drug regimens, either increasing them or decreasing them, on follow-up biopsy is demonstratedly safe or even beneficial; from Rachel Levy and colleagues at several Israeli medical centres (Trough Concentration Response in Infliximab and Adalimumab Treated Children With Inflammatory Bowel Disease Following Treatment Adjustment: A Pharmacokinetic Model) we learn that perhaps we need not wait for clinical disease to manifest before fine- tuning drug regimens – to respond to trough drug levels may permit us to intervene proactively. Dr. Jenke assesses the weaknesses and strengths of the studies reported. Will you and he reach the same conclusions? Read the articles, listen to the podcast, and find out!