Monitoring tolerance after human liver transplantation.
The validation of reliable, non-invasive immunological assays evaluating anti-donor responsiveness in allograft recipients would provide a clinically relevant tool for the early detection of ongoing rejection process as well as for the identification of operational tolerance in the long term. A sequential approach towards immunological monitoring of allografts is proposed in this review: (i) investigations exploring the initial donor-recipient alloresponses, including the analysis of the cytokine network; (ii) investigations regarding graft acceptance and operational tolerance in long-term transplant patients, consisting in the analysis of regulatory T cells and of circulating precursors of dendritic cells, in the measurement of T cell alloreactivity as well as in the study of T cell receptor repertoires. Beside the conventional in vivo and in vitro immunological techniques, the potential applications of molecular imaging in transplantation also deserve further exploration, with particular respect to allograft immune monitoring. Enforced collaboration between transplant clinicians and immunologists will be required to develop the translational research protocols required for the development of immunological monitoring, within an international multicentric network.
Wieërs
Grégoire
G
Pediatric Liver Transplant Program, Saint-Luc University Clinics, Université catholique de Louvain, Brussels, Belgium.
Gras
Jérémie
J
Bourdeaux
Christophe
C
Truong
Dinh Quang
DQ
Latinne
Dominique
D
Reding
Raymond
R
D017637:Clonal Deletion; D016207:Cytokines / Q000032:analysis / Q000235:genetics / Q000378:metabolism; D003713:Dendritic Cells / Q000276:immunology; D003952:Diagnostic Imaging; D016031:Liver Transplantation / Q000276:immunology*; D015166:Monitoring, Immunologic / Q000379:methods*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D018183:Transplantation Chimera; D023001:Transplantation Tolerance
D016207:Cytokines