Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review
Since the first liver transplantation operation (LT) in 1967 by Thomas Starzl, efforts to increase survival and prevent rejection have taken place. The development of calcineurin inhibitors (CNIs) in the 1980s led to a surge in survival post-transplantation, and since then, strategies to prevent gra...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-11-01
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| Series: | Transplantology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-3943/2/4/42 |
| _version_ | 1797500207950200832 |
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| author | Islam B Mohamed Fuad Z Aloor Prasun K Jalal |
| author_facet | Islam B Mohamed Fuad Z Aloor Prasun K Jalal |
| author_sort | Islam B Mohamed |
| collection | DOAJ |
| description | Since the first liver transplantation operation (LT) in 1967 by Thomas Starzl, efforts to increase survival and prevent rejection have taken place. The development of calcineurin inhibitors (CNIs) in the 1980s led to a surge in survival post-transplantation, and since then, strategies to prevent graft loss and preserve long-term graft function have been prioritized. Allograft rejection is mediated by the host immune response to donor antigens. Prevention of rejection can be achieved through either immunosuppression or induction of tolerance. This leads to a clinical dilemma, as the choice of an immunosuppressive agent is not an easy task, with considerable patient and graft-related morbidities. On the other hand, the induction of graft tolerance remains a challenge. Despite the fact that the liver exhibits less rejection than any other transplanted organs, spontaneous graft tolerance is rare. Most immunosuppressive medications have been incriminated in renal, cardiovascular, and neurological complications, relapse of viral hepatitis, and recurrence of HCC and other cancers. Efforts to minimize immunosuppression are directed toward decreasing medication side effects, increasing cost effectiveness, and decreasing economic burden without increasing the risk of rejection. In this article, we will discuss recent advances in strategies for improving immunosuppression following liver transplantation. |
| first_indexed | 2024-03-10T03:58:35Z |
| format | Article |
| id | doaj.art-fb5b1586b3d1447f92b509e14155c6cb |
| institution | Directory Open Access Journal |
| issn | 2673-3943 |
| language | English |
| last_indexed | 2024-03-10T03:58:35Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Transplantology |
| spelling | doaj.art-fb5b1586b3d1447f92b509e14155c6cb2023-11-23T10:51:27ZengMDPI AGTransplantology2673-39432021-11-012444145410.3390/transplantology2040042Strategies to Improve Immune Suppression Post-Liver Transplantation: A ReviewIslam B Mohamed0Fuad Z Aloor1Prasun K Jalal2Division of Gastroenterology, Baylor College of Medicine, Baylor Clinic 6620 Main Street, Suite 1450, Houston, TX 77030, USADivision of Gastroenterology, Baylor College of Medicine, Baylor Clinic 6620 Main Street, Suite 1450, Houston, TX 77030, USADivision of Gastroenterology, Baylor College of Medicine, Baylor Clinic 6620 Main Street, Suite 1450, Houston, TX 77030, USASince the first liver transplantation operation (LT) in 1967 by Thomas Starzl, efforts to increase survival and prevent rejection have taken place. The development of calcineurin inhibitors (CNIs) in the 1980s led to a surge in survival post-transplantation, and since then, strategies to prevent graft loss and preserve long-term graft function have been prioritized. Allograft rejection is mediated by the host immune response to donor antigens. Prevention of rejection can be achieved through either immunosuppression or induction of tolerance. This leads to a clinical dilemma, as the choice of an immunosuppressive agent is not an easy task, with considerable patient and graft-related morbidities. On the other hand, the induction of graft tolerance remains a challenge. Despite the fact that the liver exhibits less rejection than any other transplanted organs, spontaneous graft tolerance is rare. Most immunosuppressive medications have been incriminated in renal, cardiovascular, and neurological complications, relapse of viral hepatitis, and recurrence of HCC and other cancers. Efforts to minimize immunosuppression are directed toward decreasing medication side effects, increasing cost effectiveness, and decreasing economic burden without increasing the risk of rejection. In this article, we will discuss recent advances in strategies for improving immunosuppression following liver transplantation.https://www.mdpi.com/2673-3943/2/4/42liver transplantationimmune tolerancegraft rejectionimmunosuppressive drugs |
| spellingShingle | Islam B Mohamed Fuad Z Aloor Prasun K Jalal Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review Transplantology liver transplantation immune tolerance graft rejection immunosuppressive drugs |
| title | Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review |
| title_full | Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review |
| title_fullStr | Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review |
| title_full_unstemmed | Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review |
| title_short | Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review |
| title_sort | strategies to improve immune suppression post liver transplantation a review |
| topic | liver transplantation immune tolerance graft rejection immunosuppressive drugs |
| url | https://www.mdpi.com/2673-3943/2/4/42 |
| work_keys_str_mv | AT islambmohamed strategiestoimproveimmunesuppressionpostlivertransplantationareview AT fuadzaloor strategiestoimproveimmunesuppressionpostlivertransplantationareview AT prasunkjalal strategiestoimproveimmunesuppressionpostlivertransplantationareview |