title: Markers of acute rejection and graft acceptance in liver transplantation.
abstract: The evaluation of the immunosuppression state in liver transplanted patients is crucial for a correct post-transplant management and a major step towards the personalisation of the immunosuppressive therapy. However, current immunological monitoring after liver transplantation relies mainly on clinical judgment and on immunosuppressive drug levels, without a proper assessment of the real suppression of the immunological system. Various markers have been studied in an attempt to identify a specific indicator of graft rejection and graft acceptance after liver transplantation. Considering acute rejection, the most studied markers are pro-inflammatory and immunoregulatory cytokines and other proteins related to inflammation. However there is considerable overlap with other conditions, and only few of them have been validated. Standard liver tests cannot be used as markers of graft rejection due to their low sensitivity and specificity and the weak correlation with the severity of histopathological findings. Several studies have been performed to identify biomarkers of tolerance in liver transplanted patients. Most of them are based on the analysis of peripheral blood samples and on the use of transcriptional profiling techniques. Amongst these, NK cell-related molecules seem to be the most valid marker of graft acceptance, whereas the role CD4+CD25+Foxp3+ T cells has still to be properly defined.
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Giacomo
authors: G
authors: Germani
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Kryssia
authors: K
authors: Rodriguez-Castro
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Francesco Paolo
authors: FP
authors: Russo
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Marco
authors: M
authors: Senzolo
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Alberto
authors: A
authors: Zanetto
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Alberto
authors: A
authors: Ferrarese
authors: Giacomo Germani, Kryssia Rodriguez-Castro, Francesco Paolo Russo, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors: Patrizia
authors: P
authors: Burra
mesh_terms: D000208:Acute Disease; D000818:Animals; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood* / Q000235:genetics; D020869:Gene Expression Profiling; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000276:immunology* / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007111:Immunity, Cellular; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000097:blood*; D016031:Liver Transplantation / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D023001:Transplantation Tolerance; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators
keywords: Acute cellular rejection; Biomarkers; Liver transplantation; Tolerance
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