The immunological monitoring of alloreactive responses in liver transplant recipients: a review.
The aim of this work is to review the current knowledge in the field of immunological monitoring of allogenic responsiveness in clinical liver transplantation. When compared to other solid-organ transplants, liver allografts are considered as immunologically privileged, and, accordingly, constitute a favorable setting to develop experimental as well as clinical strategies for minimization of immunosuppression and even induction of operational tolerance. The validation of simple, reliable, noninvasive assays exploring antidonor alloreactivity will constitute a crucial step toward implementing such approaches in the clinic. In contrast to research in rodents claiming the development of donor-specific tolerance in case of graft survivals of over 100 days without immunosuppression, it is impractical to confirm tolerance induction in this way in humans. Promising candidate assays include the detection of post-transplant immune deviation, of circulating precursors of dendritic cells subtypes, and of regulatory T cells. A conceptual framework for the development of tolerance assays in clinical liver transplantation is also proposed.
Pediatric Liver Transplant Program, Saint-Luc University Clinics, Université Catholique de Louvain, Brussels, Belgium. reding@chex.ucl.ac.be
Raymond
R
Reding
Jérémie
J
Gras
Dinh Quang
DQ
Truong
Grégoire
G
Wieërs
Dominique
D
Latinne
D015415:Biomarkers / Q000097:blood*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology; D016031:Liver Transplantation / Q000276:immunology* / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D011379:Prognosis; D014181:Transplantation Immunology / Q000502:physiology*; D014184:Transplantation, Homologous / Q000276:immunology*
D015415:Biomarkers