TY  - JOUR
AU  - Hamdani, Salim
AU  - Azoulay, Daniel
PY  - 2019
DA  - 2019/09/04
TI  - Benefits of Combined Liver Transplant: Protection or Tolerance?
JO  - OBM Transplantation
SP  - 084
VL  - 03
IS  - 03
AB  - The privileged liver by its immunological status is described as a tolerogenic organ. However, these alone do not explain the installation of a tolerance after single or combined liver transplantation (kidney, heart, pancreas, intestine). Other factors appear to be involved in the identification of patients likely to be tolerant to their graft, such as recipient age, donor hepatic volume, iron metabolism, biomarkers, or imprint of cytomegalovirus infection. All of these factors seem to favor graft tolerance. The use of non-specific immunosuppressive drugs during organ transplantation has significantly reduced the incidence of acute rejection, but does not protect the patient from the deleterious effects of chronic immunosuppression. As such, different approaches (stem cells infusion, Treg therapy, immunosuppression conversion) have been taken to reduce or discontinue immunosuppressive therapy. The results are promising. This recent review of the literature examines the mechanisms of operational tolerance after hepatic transplantation, as well as the current means of early identification of patients who may be candidates for operational tolerance.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.1903084
DO  - 10.21926/obm.transplant.1903084
ID  - Hamdani2019
ER  -