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Abstract
Cell therapies using immune cells or non-parenchymal cells of the liver have emerged as potential treatments to facilitate immunosuppression withdrawal and to induce operational tolerance in liver transplant (LT) recipients. Recent pre-clinical and clinical trials of cellular therapies including regulatory T cells, regulatory dendritic cells, and mesenchymal cells have shown promising results. Here we briefly summarize current concepts of cellular therapy for induction of operational tolerance in LT recipients.
Highlights
Transplantation of organs, including the liver, across the HLA barrier induces strong alloimmune responses in recipients
Transplant tolerance represents the holy grail for transplant immunology: a state where the allograft is accepted by the recipient in the absence of IS treatment
Simultaneous donor bone marrow hematopoietic stem cell infusion with liver transplant (LT) increases the risk of graft versus host disease (GVHD) when compared to LTs alone; two out of 29 patients from Rao’s study group developed GVHD [19]
Summary
Transplantation of organs, including the liver, across the HLA barrier induces strong alloimmune responses in recipients. Both cellular and humoral alloresponses contribute to rejection. Current immunosuppressive (IS) therapies including calcineurin inhibitors (cyclosporin and tacrolimus) and corticosteroids target recipient T cell activation, expansion, and cytotoxicity effectively, and reduce acute rejections to less than 15% of transplants but their long-term use is associated with increased risk of infections and malignancies [1,2]. Induction of immune tolerance decreases the risk of graft rejection after solid organ transplantation and reduces the need for immunosuppression and improves the survival of transplanted organs.
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