*Purpose: Some studies correlate Angiotensin II Type 1 Receptor (AT1R) antibodies (Ab) with the development of rejection, vascular complications, and allograft dysfunction in pediatric solid organ transplant recipients (PSOT). AT1R Ab screening, surveillance, therapeutic strategies and the state of national practice have not been defined.

*Methods: A brief survey was sent electronically to the medical director of each pediatric liver and kidney transplant program in America to characterize PSOT AT1R Ab screening and management practices. Responses were analyzed anonymously.

*Results: 36/90 PSOT kidney programs and 10/33 PSOT liver programs responded to the survey. Respondents were experienced physicians, with 80% of hepatologists and 94.4% of nephrologists with >5 years spent in their current role. A majority of responding centers offered transplantation of multiple different organs. Intervening centers tailored management strategy to the clinical scenario and/or antibody detection (Table).AT1R Ab screening was uncommon in liver transplant programs, with only 1 program (10%) reporting routine pre-PSOT screening and one program (10%) reporting screening post-PSOT in the setting of rejection.There is lack of consensus in the PSOT community regarding the clinical relevance of AT1R. More than half of responding PSOT kidney programs believe that AT1R does have relevance, while PSOT liver programs are evenly split between being unsure of AT1R Ab relevance and feeling that AT1R Ab is irrelevant. Respondents also cited concerns about the accessibility and validity of current testing methods.

*Conclusions: This survey provides a snapshot of the current clinical climate surrounding AT1R Ab in PSOT, with a diversity of screening and management strategies employed nationally.

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