Understanding, predicting and achieving liver transplant tolerance: from bench to bedside.
Details
Serval ID
serval:BIB_01FA7C8C7635
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Understanding, predicting and achieving liver transplant tolerance: from bench to bedside.
Journal
Nature reviews. Gastroenterology & hepatology
ISSN
1759-5053 (Electronic)
ISSN-L
1759-5045
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
17
Number
12
Pages
719-739
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
In the past 40 years, liver transplantation has evolved from a high-risk procedure to one that offers high success rates for reversal of liver dysfunction and excellent patient and graft survival. The liver is the most tolerogenic of transplanted organs; indeed, immunosuppressive therapy can be completely withdrawn without rejection of the graft in carefully selected, stable long-term liver recipients. However, in other recipients, chronic allograft injury, late graft failure and the adverse effects of anti-rejection therapy remain important obstacles to improved success. The liver has a unique composition of parenchymal and immune cells that regulate innate and adaptive immunity and that can promote antigen-specific tolerance. Although the mechanisms underlying liver transplant tolerance are not well understood, important insights have been gained into how the local microenvironment, hepatic immune cells and specific molecular pathways can promote donor-specific tolerance. These insights provide a basis for the identification of potential clinical biomarkers that might correlate with tolerance or rejection and for the development of novel therapeutic targets. Innovative approaches aimed at promoting immunosuppressive drug minimization or withdrawal include the adoptive transfer of donor-derived or recipient-derived regulatory immune cells to promote liver transplant tolerance. In this Review, we summarize and discuss these developments and their implications for liver transplantation.
Keywords
Animals, Graft Rejection/immunology, Graft Survival/drug effects, Graft Survival/immunology, Humans, Immunosuppressive Agents/pharmacology, Liver/immunology, Liver Transplantation, Mice, Rats, Transplantation Tolerance/drug effects, Transplantation Tolerance/immunology, Withholding Treatment
Pubmed
Web of science
Create date
17/08/2020 10:15
Last modification date
09/10/2021 5:39