title: Immunosuppression: trends and tolerance?
abstract: Advances in pharmacologic immunosuppression are responsible for the excellent outcomes experienced by recipients of liver transplants. However, long-term follow-up of these patients reveals an increasing burden of morbidity and mortality that is attributable to these drugs. The authors summarize the agents used in contemporary liver transplantation immunosuppression protocols and discuss the emerging trend within the community to minimize or eliminate these agents from use. The authors present recently published data that may provide the foundation for immunosuppression minimization or tolerance induction in the future and review studies that have focused on the utility of biomarkers in guiding immunosuppression management.
authors.affiliation: Division of Liver Transplantation, Department of Surgery, The University of Pennsylvania, 3400 Spruce Street, One Founders Pavilion, Philadelphia, PA 19104, USA.
authors.forename: Paige M
authors.initials: PM
authors.lastname: Porrett
authors.affiliation: Department of Surgery, The University of Pennsylvania, 3400 Spruce Street, Two Dulles Pavilion, Philadelphia, PA 19104, USA.
authors.forename: Sohaib K
authors.initials: SK
authors.lastname: Hashmi
authors.affiliation: Division of Liver Transplantation, Department of Surgery, Penn Transplant Institute, The University of Pennsylvania, 3400 Spruce Street, Two Dulles Pavilion, Philadelphia, PA 19104, USA. Electronic address: abraham.shaked@uphs.upenn.edu.
authors.forename: Abraham
authors.initials: A
authors.lastname: Shaked
mesh_terms: D000328:Adult; D000818:Animals; D002648:Child; D002986:Clinical Trials as Topic; D005260:Female; D019698:Hepatitis C, Chronic / Q000601:surgery; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods / Q000639:trends*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007239:Infections / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000517:prevention & control; D016030:Kidney Transplantation; D016031:Liver Transplantation / Q000379:methods / Q000639:trends*; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000517:prevention & control; D018448:Models, Immunological; D009369:Neoplasms / Q000209:etiology / Q000517:prevention & control; D057285:Precision Medicine; D012008:Recurrence; D023001:Transplantation Tolerance / Q000187:drug effects / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents
keywords: Biomarkers; Immunosuppression; Minimization; Tolerance