Textbook of Liver Transplantation - A Multidisciplinary Approach
Textbook of Liver Transplantation - A Multidisciplinary Approach
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肝移植教科书 - 多学科方法
DOI：
10.1007/978-3-030-82930-8_45
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Lim T
中科院分区：
文献类型：
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作者：
Lim T
虽然手术技术和免疫抑制治疗（IST）方案的进步已导致肝移植（LT）中移植物和患者存活率的改善，但长期免疫抑制仍与显著的发病率和死亡率相关。这些包括恶性肿瘤、感染、代谢紊乱和慢性肾脏疾病的风险增加，以及与这些治疗相关的高成本和所需的药物监测。因此，移植临床医生试图在不发生排斥反应的情况下完全停止免疫抑制，称为“操作耐受”（OT）。LT构成了研究同种异体移植耐受机制的独特临床环境，因为它是唯一一种相当大比例的受者自发产生耐受的移植方式。在这里，我们讨论了已经研究过的各种策略，以实现宽容。
Whilst advances in surgical techniques and immunosuppression therapy (IST) regimens have led to improved graft and patient survival in liver transplantation (LT), long-term immunosuppression is still associated with significant morbidity and mortality. These include increased risk of malignancy, infection, metabolic disorders and chronic kidney disease, as well as high costs associated to these therapies and required drug monitoring. As a result, transplant clinicians have attempted to achieve complete discontinuation of immunosuppression without development of rejection, termed “operational tolerance” (OT). LT constitutes a unique clinical setting to investigate the mechanisms of allograft tolerance, given that it is the only transplant modality in which substantial proportion of recipients spontaneously develop tolerance. Here, we discuss the various strategies that have been studied to achieve tolerance.