New Approaches to the Diagnosis of Rejection and Prediction of Tolerance in Liver Transplantation

被引:10
|
作者
Taner, Timucin [1 ]
Bruner, Julia [2 ]
Emamaullee, Juliet [3 ]
Bonaccorsi-Riani, Eliano [4 ,5 ]
Zarrinpar, Ali [2 ]
机构
[1] Mayo Clin, Dept Surg, Coll Med, Rochester, MN USA
[2] Univ Florida, Coll Med, Dept Surg, 1600 SW Archer Rd, Gainesville, FL 32608 USA
[3] Univ Southern Calif, Keck Sch Med, Dept Surg, Los Angeles, CA 90007 USA
[4] Catholic Univ Louvain, Dept Surg, Abdominal Transplant Unit, Clin Univ St Luc, Brussels, Belgium
[5] Catholic Univ Louvain, Pole Chirurg Expt & Transplantat, Brussels, Belgium
基金
美国国家卫生研究院;
关键词
ACUTE CELLULAR REJECTION; BLOOD MONONUCLEAR-CELLS; SERUM MIRNA SIGNATURE; OPERATIONAL TOLERANCE; PERIPHERAL-BLOOD; FREE DNA; T-CELLS; ALLOGRAFT-REJECTION; MEDIATED REJECTION; RECIPIENTS;
D O I
10.1097/TP.0000000000004160
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Immunosuppression after liver transplantation is essential for preventing allograft rejection. However, long-term drug toxicity and associated complications necessitate investigation of immunosuppression minimization and withdrawal protocols. Development of such protocols is hindered by reliance on current paradigms for monitoring allograft function and rejection status. The current standard of care for diagnosis of rejection is histopathologic assessment and grading of liver biopsies in accordance with the Banff Rejection Activity Index. However, this method is limited by cost, sampling variability, and interobserver variation. Moreover, the invasive nature of biopsy increases the risk of patient complications. Incorporating noninvasive techniques may supplement existing methods through improved understanding of rejection causes, hepatic spatial architecture, and the role of idiopathic fibroinflammatory regions. These techniques may also aid in quantification and help integrate emerging -omics analyses with current assessments. Alternatively, emerging noninvasive methods show potential to detect and distinguish between different types of rejection while minimizing risk of adverse advents. Although biomarkers have yet to replace biopsy, preliminary studies suggest that several classes of analytes may be used to detect rejection with greater sensitivity and in earlier stages than traditional methods, possibly when coupled with artificial intelligence. Here, we provide an overview of the latest efforts in optimizing the diagnosis of rejection in liver transplantation.
引用
收藏
页码:1952 / 1962
页数:11
相关论文
共 50 条
  • [1] Liver transplantation: Rejection and tolerance
    Taner, Timucin
    [J]. LIVER TRANSPLANTATION, 2017, 23 : S85 - S88
  • [2] New approaches to diagnosis of rejection
    Nicholas A. Zwang
    Laurence A. Turka
    [J]. Nature Reviews Nephrology, 2014, 10 : 72 - 74
  • [3] New approaches to diagnosis of rejection
    Zwang, Nicholas A.
    Turka, Laurence A.
    [J]. NATURE REVIEWS NEPHROLOGY, 2014, 10 (02) : 72 - 74
  • [4] Unique Aspects of Rejection and Tolerance in Liver Transplantation
    Knechtle, Stuart J.
    Kwun, Jean
    [J]. SEMINARS IN LIVER DISEASE, 2009, 29 (01) : 91 - 101
  • [5] DIAGNOSIS OF REJECTION IN LIVER-TRANSPLANTATION
    HOCKERSTEDT, K
    LAUTENSCHLAGER, I
    SCHEININ, TM
    AHONEN, J
    EKLUND, B
    HAYRY, P
    KORSBACK, C
    MAURY, P
    SALMELA, K
    TASKINEN, E
    [J]. TRANSPLANTATION PROCEEDINGS, 1987, 19 (01) : 2483 - 2484
  • [6] PROTEIN BIOMARKERS FOR DIAGNOSIS AND PREDICTION OF ACUTE CELLULAR REJECTION AFTER LIVER TRANSPLANTATION
    Raschzok, N.
    Reutzel-Selke, A.
    Schmuck, R. B.
    Morgul, M. H.
    Gauger, U.
    Leder, A.
    Struecker, B.
    Boas-Knoop, S.
    Bartels, M.
    Jonas, S.
    Lojewski, C.
    Puhl, G.
    Seehofer, D.
    Bahra, M.
    Pascher, A.
    Neuhaus, P.
    Pratschke, J.
    Sauer, I. M.
    [J]. TRANSPLANT INTERNATIONAL, 2014, 27 : 39 - 39
  • [7] NEW APPROACHES TO TRANSPLANTATION TOLERANCE
    SMITH, CV
    ROSENGARD, BR
    GUZZETTA, PC
    NAKAJIMA, K
    SACHS, DH
    [J]. TRANSPLANTATION PROCEEDINGS, 1991, 23 (04) : 2157 - 2161
  • [8] Prediction of acute cellular rejection in liver transplantation
    Bathgate, A
    Hynds, P
    Dollinger, M
    Hayes, PC
    [J]. GUT, 1997, 41 : A239 - A239
  • [9] DIAGNOSIS OF ACUTE REJECTION IN LIVER-TRANSPLANTATION
    HOCKERSTEDT, K
    LAUTENSCHLAGER, I
    AHONEN, J
    EKLUND, B
    ISONIEMI, H
    KORSBACK, C
    MAKINEN, J
    MAKISALO, H
    ORKO, R
    PETTERSSON, E
    SALASPURO, M
    SCHEININ, B
    SCHEININ, TM
    VONWILLEBRAND, E
    [J]. JOURNAL OF HEPATOLOGY, 1988, 6 (02) : 217 - 221
  • [10] DIAGNOSIS AND PREVENTION OF REJECTION IN PIG LIVER TRANSPLANTATION
    TAUBER, J
    STIRNEMANN, H
    DEWECK, A
    SCHOLL, E
    STREBEL, H
    VOGEL, R
    WEBER, M
    SCHILDT, W
    BUHLER, L
    SEEBERGER, B
    BUCHER, U
    BURGI, U
    [J]. DIGESTION, 1971, 4 (03) : 181 - +