User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

An appraisal of tolerance in liver transplantation.

Primary tabs

Lerut, Jan [UCL] Sanchez-Fueyo, A.

Human liver allografts have a lower susceptibility to rejection than other organs. In addition, in some liver transplant recipients immunosuppressive drugs can be completely withdrawn, and these patients are considered as 'operationally' tolerant. Careful scrutiny of accumulated clinical experience indicates that elective immunosuppressive drug weaning is feasible in almost 20% of selected liver transplant recipients. This is associated with an incidence of 12% to 76% of acute cellular rejection, but these episodes are commonly mild and often resolve by return to baseline immunosuppression (IS), many times without the need to administer steroid boluses. Study of tolerance in liver transplantation (LT) has been hampered by confusion regarding the definitions of rejection and tolerance, and by the absence of prospective studies correlating results of immune monitoring assays and clinical outcome. Thus, we lack a clinically validated treatment-stopping rule capable of predicting the success of IS withdrawal and this procedure has to be performed on a 'trial and error' basis. The search for an accurate means to identify allograft tolerance among immunosuppressed recipients should become a priority in LT research. This information would provide a biological basis for guiding IS withdrawal protocols and for the implementation of tolerance-promoting strategies in LT.

Document type Article de périodique (Journal article) – Journal Article, Research Support, Non-U.S. Gov't, Review
Access type Accès restreint
Publication date 2006
Journal information "American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons" - Vol. 6, no. 8, p. 1774-80 (2006)
Peer reviewed yes
issn 1600-6135
Publication status Publié
Affiliations UCL - (SLuc) Service de chirurgie et transplantation abdominale
UCL - MD/CHIR - Département de chirurgie
MESH Subject Animals ; Graft Rejection - immunology - prevention & control ; Humans ; Immune Tolerance - immunology ; Immunosuppressive Agents - pharmacology ; Liver Transplantation - immunology
Links
  1. Markus BH, Transplantation, 46, 372 (1988)
  2. Calne Roy, Davies Hugh, Organ graft tolerance: the liver effect, 10.1016/s0140-6736(94)90809-5
  3. Lerut Jan P., Avoiding steroids in solid organ transplantation, 10.1111/j.1432-2277.2003.tb00291.x
  4. Wiesner Russell H., Shorr Jolene S., Steffen Bettina J., Chu Alice H., Gordon Robert D., Lake John R., Mycophenolate mofetil combination therapy improves long-term outcomes after liver transplantation in patients with and without hepatitis C, 10.1002/lt.20453
  5. Starzl Thomas E, Murase Noriko, Abu-Elmagd Kareem, Gray Edward A, Shapiro Ron, Eghtesad Bijan, Corry Robert J, Jordan Mark L, Fontes Paulo, Gayowski Tim, Bond Geoffrey, Scantlebury Velma P, Potdar Santosh, Randhawa Parmjeet, Adriana Zeevi Tong Wu, Nalesnik Michael A, Woodward Jennifer, Marcos Amadeo, Trucco Massimo, Demetris Anthony J, Fung John J, Tolerogenic immunosuppression for organ transplantation, 10.1016/s0140-6736(03)13175-3
  6. Demetris AJ, Am J Pathol, 138, 609 (1991)
  7. McVicar John P., Kowdley Kris V., Bacchi Carlos E., Barr Darlene, Marsh Christopher L., Perkins James D., Carithers Robert L., The natural history of untreated focal allograft rejection in liver transplant recipients, 10.1002/lt.500020212
  8. Cobbold Steve, Waldmann Herman, Infectious tolerance, 10.1016/s0952-7915(98)80217-3
  9. Calne R. Y., Prope tolerance: the future of organ transplantation???from the laboratory to the clinic : , 10.1097/01.tp.0000117776.14277.03
  10. Starzl T, Cell migration and chimerism after whole-organ transplantation: The basis of graft acceptance, 10.1016/0270-9139(93)90133-8
  11. Manez R, Transplantation, 57, 149 (1994)
  12. Massarollo P.C.B, Mies S, Abdala E, Leitão R.M.C, Raia S, Immunosuppression Withdrawal for Treatment of Severe Infections in Liver Transplantation, 10.1016/s0041-1345(98)00321-2
  13. Hurwitz Melissa, Desai Dev M., Cox Kenneth L., Berquist William E., Esquivel Carlos O., Millan Maria T., Complete immunosuppressive withdrawal as a uniform approach to post-transplant lymphoproliferative disease in pediatric liver transplantation, 10.1111/j.1399-3046.2004.00129.x
  14. Devlin John, Doherty Derek, Thomson Linda, Wong Terence, Donaldson Peter, Portmann Bernard, Williams Roger, Defining the outcome of immunosuppression withdrawal after liver transplantation, 10.1002/hep.510270406
  15. Mazariegos George V., Reyes Jorge, Marino Ignazio R., Demetris Anthony J., Flynn Bridget, Irish William, McMichael John, Fung John J., Starzl Thomas E., WEANING OF IMMUNOSUPPRESSION IN LIVER TRANSPLANT RECIPIENTS12 : , 10.1097/00007890-199701270-00012
  16. Pons Jos?? A., Y??lamos Jos??, Ram??rez Pablo, Oliver-Bonet Mar??a, S??nchez Alicia, Rodr??guez-Gago Manolo, Navarro Joaquima, Bermejo Juan, Robles Ricardo, Parrilla Pascual, Endothelial cell chimerism does not influence allograft tolerance in liver transplant patients after withdrawal of immunosuppression1 : , 10.1097/01.tp.0000058472.71775.7d
  17. Eason James D., Cohen Ari J., Nair Satheesh, Alcantera Teresita, Loss George E., Tolerance: Is It Worth the Risk? : , 10.1097/01.tp.0000162084.46555.10
  18. Takatsuki Mitsuhisa, Uemoto Shinji, Inomata Yukihiro, Egawa Hiroto, Kiuchi Tetsuya, Fujita Shiro, Hayashi Michihiro, Kanematsu Takashi, Tanaka Koichi, WEANING OF IMMUNOSUPPRESSION IN LIVING DONOR LIVER TRANSPLANT RECIPIENTS1 : , 10.1097/00007890-200108150-00016
  19. Tryphonopoulos Panagiotis, Tzakis Andreas G., Weppler Debbie, Garcia-Morales Rolando, Kato Tomoaki, Madariaga Juan R., Levi David M., Nishida Seigo, Moon Jang, Selvaggi Gennaro, Regev Arie, Nery Caio, Bejarano Pablo, Khaled Amr, Kleiner Gary, Esquenazi Violet, Miller Joshua, Ruiz Philip, Ricordi Camillo, The Role of Donor Bone Marrow Infusions in Withdrawal of Immunosuppression in Adult Liver Allotransplantation, 10.1111/j.1600-6143.2004.00743.x
  20. Tisone Giuseppe, Orlando Giuseppe, Cardillo Andrea, Palmieri Giampiero, Manzia Tommaso Maria, Baiocchi Leonardo, Lionetti Raffaella, Anselmo Alessandro, Toti Luca, Angelico Mario, Complete weaning off immunosuppression in HCV liver transplant recipients is feasible and favourably impacts on the progression of disease recurrence, 10.1016/j.jhep.2005.11.047
  21. Mazariegos George V., Zahorchak Alan F., Reyes Jorge, Ostrowski Lynn, Flynn Bridget, Zeevi Adriana, Thomson Angus W., Dendritic Cell Subset Ratio in Peripheral Blood Correlates with Successful Withdrawal of Immunosuppression in Liver Transplant Patients, 10.1034/j.1600-6143.2003.00109.x
  22. Shodell M., Siegal F. P., Circulating, Interferon-Producing Plasmacytoid Dendritic Cells Decline During Human Ageing, 10.1046/j.1365-3083.2002.01148.x
  23. Hackstein Holger, Renner Fabrice C., Bohnert Anette, Nockher Angelika, Frommer Ture, Bein Gregor, Weimer Rolf, Dendritic Cell Deficiency in the Blood of Kidney Transplant Patients on Long-Term Immunosuppression: Results of a Prospective Matched-Cohort Study : Dendritic Cell Precursor Deficiency After Kidney Transplantation, 10.1111/j.1600-6143.2005.01101.x
  24. Girlanda R., Rela M., Williams R., O’Grady J.G., Heaton N.D., Long-Term Outcome of Immunosuppression Withdrawal After Liver Transplantation, 10.1016/j.transproceed.2005.03.070
  25. Oike F, Yokoi A, Nishimura E, Ogura Y, Fujimoto Y, Kasahara M, Kaihara S, Kiuchi T, Egawa H, Uemoto S, Tanaka K, Complete withdrawal of immunosuppression in living donor liver transplantation, 10.1016/s0041-1345(02)02980-9
  26. Takatsuki Mitsuhisa, Uemoto Shinji, Inomata Yukihiro, Sakamoto Seisuke, Hayashi Michihiro, Ueda Mikiko, Kanematsu Takashi, Tanaka Koichi, Analysis of alloreactivity and intragraft cytokine profiles in living donor liver transplant recipients with graft acceptance, 10.1016/s0966-3274(01)00027-2
  27. Li Ying, Koshiba Takaaki, Yoshizawa Atsushi, Yonekawa Yukihide, Masuda Kosuke, Ito Atsushi, Ueda Mikiko, Mori Takahide, Kawamoto Hiroshi, Tanaka Yoshimasa, Sakaguchi Shimon, Minato Nagahiro, Wood Kathryn J., Tanaka Koichi, Analyses of Peripheral Blood Mononuclear Cells in Operational Tolerance After Pediatric Living Donor Liver Transplantation, 10.1111/j.1600-6143.2004.00611.x
  28. Ueda M, Liver Transpl, 11, 122 (2006)
  29. Sebagh M, All liver recipients benefit from the protocol 10-year liver biopsies, 10.1053/jhep.2003.50231
  30. Anand AC, Transplantation, 60, 1098 (1995)
  31. Pappo O, Am J Surg Pathol, 19, 192 (1995)
Bibliographic reference Lerut, Jan ; Sanchez-Fueyo, A.. An appraisal of tolerance in liver transplantation.. In: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, Vol. 6, no. 8, p. 1774-80 (2006)
Permanent URL http://hdl.handle.net/2078.1/10674