medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2011, Number 3

<< Back Next >>

Ann Hepatol 2011; 10 (3)

Operational tolerance after liver transplantation, more common than we think: A case report

Benítez C, Arancibia JP, Arrese M, Soza A, Domínguez P, Jarufe N, Martínez J, Pérez-Ayuso RM

Language: Spanish
References: 33
Page: 361-364
PDF size: 41.55 Kb.


ABSTRACT

Operational tolerance after liver transplantation has been described in around 20% of the recipients. These patients are able to maintain a normal graft function in the absence of immunosuppressive drugs, thus being free of adverse effects that are common and frequently severe. Here we present a well-documented case of operational tolerance after liver transplantation and discuss current concepts on this topic with emphasis on recent findings that will potentially allow for identifying graft-tolerant patients.


REFERENCES

  1. European Liver Transplant Registry. Available from: http:/ /www.eltr.org/ [September 2010].

  2. Mells G, Neuberger J. Long-term care of the liver allograft recipient. Semin Liver Dis 2009; 29: 102-20.

  3. Billingham RE, Brent L, Medawar PB. Actively acquired tolerance of foreign cells. Nature 1953; 172: 603-6.

  4. Lerut J, Sanchez-Fueyo A. Am J Transplant 2006; 6: 1774-80.

  5. Sánchez-Fueyo A, Strom T. Immunologic basis of graft rejection and tolerance following transplantation of liver or other solid organs. Gastroenterology 2011; 140: 51-64.

  6. Devlin J, Doherty D, Thomson L, Wong T, Donaldson P, Portmann B, et al. Defining the outcome of immunosuppression withdrawal after liver transplantation. Hepatology 1998; 27: 926-33.

  7. Mazariegos GV, Reyes J, Marino IR, Demetris AJ, Flynn B, Irish W, et al. Weaning of immunosuppression in liver transplant recipients. Transplantation 1997; 63: 243-9.

  8. Pons JA, Revilla-Nuin B, Baroja-Mazo A, Ramírez P, Martínez- Alarcón L, Sanchez-Bueno F, et al. FoxP3 in peripheral blood is associated with operational tolerance in liver transplant patients during immunosuppression withdrawal. Transplantation 2008; 86: 1370-8.

  9. Pons JA, Yélamos J, Ramírez P, Oliver-Bonet M, Sánchez A, Rodríguez-Gago M, et al. Endothelial cell chimerism does not influence allograft tolerance in liver transplant patients after withdrawal of immunosuppression. Transplantation 2003; 75: 1045-7.

  10. Orlando G, Manzia T, Baiocchi, Sanchez-Fueyo A, Angelico M, Tisone G. The Tor Vergata weaning off immunosuppression protocol in stable HCV liver transplant patients: the updated follow up at 78 months. Transpl Immunol 2008; 20: 43-7.

  11. Eason JD, Cohen AJ, Nair S, Alcantera T, Loss GE. Tolerance: is it worth the risk? Transplantation 2005; 79: 1157-9.

  12. Takatsuki M, Uemoto S, Inomata Y, Egawa H, Kiuchi T, Fujita S, et al. Weaning of immunosuppression in living donor liver transplant recipients. Transplantation 2001; 72: 449-54.

  13. Tryphonopoulos P, Tzakis AG, Weppler D, García-Morales R, Kato T, Madariaga JR, et al. The role of donor bone marrow infusions in withdrawal of immunosuppression in adult liver allotransplantation. Am J transplant 2005; 5: 608-13.

  14. Girlanda R, Rela M, Williams R, O’Grady JG, Heaton ND. Long-term outcome of immunosuppression withdrawal after liver transplantation. Transplant Proc 2005; 37: 1708-9.

  15. Assy N, Adams PC, Myers P, Simon V, Minuk GY, Wall W, et al. Randomized controlled trial of total immunosuppression withdrawal in liver transplant recipients: role of ursodeoxycholic acid. Transplantation 2007; 83: 1571-6.

  16. Benitez C, Lozano JJ, Martinez-Llordella M, Puig-Pey I, Lopez M, Rodriguez A, et al. Use of transcriptional biomarkers to identify liver transplant recipients who can successfully discontinue immunesuppressive therapy (abstract 213). Paper presented at: American Transplant Congress. May 30-Jun 03, 2009; Boston, MA. Am J Transplant 2009; 9: 252.

  17. Feng S, Ekong U, Lobritto S, Demetris A, Rosenthal P, Alonso E, et al. ITN029ST: Immunosuppresion withdrawal in pediatric recipients of parental living donor liver transplants: preliminary results of a pilot study (abstract 189). Paper presented at: American Transplant Congress; Boston, MA; May 30-Jun 03, 2009. Am J Transplant 2009; 9: 244.

  18. Mells G, Mann C, Hubscher S, Neuberger J. Late protocol liver biopsies in the liver allograft: a neglected investigations? Liver transplantation 2009; 15: 931-8.

  19. Yoshitomi M, Koshiba T, Haga H, Li Y, Zhao X, Cheng D, et al. Requirement of protocol biopsy before and after complete cessation of immunosuppression after liver transplantation. Transplantation 2009; 87: 606-14.

  20. Orlando G, Soker S, Wood K. Operational tolerance after liver transplantation. J Hepatol 2009; 50: 1247-57.

  21. Koshiba T, Li Y, Takemura M, Wu Y, Sakaguchi S, Minato N, et al. Clinical, immunological, and pathological aspects of operational tolerance after pediatric living-donor liver transplantation. Transpl Immunol 2007; 17: 94-7.

  22. Turka L, Lechler R. Towards the identification of biomarkers of transplantation tolerance. Nat Rev Immunol 2009; 9: 521-6.

  23. Girlanda R, Rela M, Williams R, O’Grady JG, Heaton ND. Long-term outcome of immunesuppression withdrawal after liver transplantation. Transplant Proc 2005; 37: 1708-9.

  24. Li Y, Koshiba T, Yoshizawa A, Yonekawa Y, Masuda K, Ito A, et al. Am J Transplant 2004; 4: 2118-25.

  25. Martínez-Llordella M, Puig-Pey I, Orlando G, Ramoni M, Tisone G, Rimola A, et al. Am J Transplant 2007; 7: 309-19.

  26. Li Y, Zhao X, Cheng D, Haga H, Tsuruyama T, Wood K, et al. Transplantation 2008; 86: 1837-43.

  27. Brouard S, Mansfield E, Braud C, Li L, Giral M, Hsieh SC, et al. Identification of peripheral blood transcriptional biomarker panel associated with operational renal allograft tolerance. Proc Natl Acad Sci USA 2007; 104: 15448-53.

  28. Braud C, Baeten D, Giral M, Pallier A, Ashton-Chess J, Braudeau C, et al. Immunosuppressive drug-free operational immune tolerance in human kidney transplant recipients: Part I. Blood gene expression statistical analysis. J Cell Biochem 2008; 103: 1681-92.

  29. Kawasaki M, Iwasaki M, Koshiba T, Fujino M, Hara Y, Kitazawa Y, et al. Gene expression profile analysis of peripheral blood mononuclear cells from tolerant living-donor liver transplant recipients. Int Surg 2007; 92: 276-86.

  30. Martínez-Llordella M, Lozano J, Puig-Pey I, Orlando G, Tisone G, Lerut J, et al. Using a transcriptional profilling to develop a diagnostic test of operational tolerance in liver transplant recipients. J Clin Invest 2008; 188: 2845-57.

  31. Alexander SI, Smith N, Hu M, Verran D, Shun A, Dorney S, et al. Chimerism and tolerance in a recipient of a deceased- donor liver transplant. N Engl J Med 2008; 358: 369-74.

  32. Scandling JD, Busque S, Dejbakhsh-Jones S, Benike C, Millan MT, Shizuru JA, et al. Tolerance and chimerism after renal and hematopoietic-cell transplantation. N Engl J Med 2008; 358: 362-8.

  33. Benítez CE, Puig-Pey I, López M, Martínez-Llordella M, Lozano JJ, Bohne F, et al. ATG-Fresenius treatment and low-dose tacrolimus: results of a randomized controlled trial in liver transplantation. Am J Transplant 2010; 10: 2296-304.




2020     |     www.medigraphic.com