Abstract
Operational tolerance (OT), defined as continued function of a transplanted organ in the absence of immunosuppression (IS) with a follow up of >1 year, appears to occur relatively frequently after liver transplantation (LTx). There is a pressing need to establish reliable biomarkers to monitor patients who may discontinue IS without risk of rejection. In addition, identification of biomarkers might provide insight into mechanisms of OT that could lead to development of novel therapies for induction of tolerance. Several potential clinical biomarkers have been identified, mainly by retrospective studies using either peripheral blood or graft biopsy tissues. These candidate biomarkers include regulatory T cells (Tregs), γδ T cells, natural killer (NK) cells, B cells, donor-specific antibody (DSA) and/or C4d deposition, dendritic cell (DC) subset ratio, serum human leukocyte antigen-G (HLA-G), and cytokine expression or polymorphism. In the next phase, further large-scale prospective studies are needed to validate existing candidate biomarkers of OT in LTx patients.
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