Strategies to tackle GvHD have generally involved steroid intensification and a variety of combinations of anti thymocyte globulin (ATG), sirolimus, ECP, ruxolitinib, IL-2 receptor blockers, and tumor necrosis factor ⍺ antibodies.4,11 Other centers performing pediatric small intestinal transplantation have described their experiences and evolution of baseline immunosuppressive strategies. The gene discussed is TNF; the disease is graft versus host disease.