Defining the outcome of immunosuppression withdrawal after liver transplantation

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
J DevlinR Williams

Abstract

Successful immunosuppression withdrawal should benefit the natural history of organ transplantation patients. To identify the clinical hazards of removing drug treatment and possible characteristics that predict a favorable outcome in long-term liver recipients, immunosuppression was withdrawn completely and the clinicopathological outcome documented in 18 liver recipients. Indication for transplantation, HLA matching, early rejection history, and presence of microchimerism were examined as predictors of outcome. Chimerism was determined by polymerase chain reaction-based examination for donor-specific HLA-DRB1 alleles and Y-gene-specific nucleotide sequences. At 3 years, 5 patients (28%) remained completely off immunosuppression; 12 patients (67%) experienced histological graft changes: acute rejection in 4, portal tract inflammation/hepatitis in 7, and necrosis in 1. Hepatitis B or C viral infections did not account for the nonrejection patterns. Unmasking of systemic disorders occurred. Chimerism, demonstrated in 7 patients (39%), with skin the optimal tissue, was not associated with tolerance. Parameters associated with successful drug withdrawal were transplantation for non-immune-mediated liver disorders, fewer donor-reci...Continue Reading

References

Jun 27, 1992·Lancet·T E StarzlM Trucco
Feb 1, 1992·Tissue Antigens·G BeinH Kirchner
Feb 1, 1991·European Journal of Immunogenetics : Official Journal of the British Society for Histocompatibility and Immunogenetics·D G Doherty, P T Donaldson
Oct 1, 1991·American Journal of Medical Genetics·Y NakagomeT Tamura
Mar 1, 1989·Transplantation·H S DaviesR Y Calne
Jan 1, 1987·The American Journal of Surgical Pathology·D C SnoverN L Ascher
Jun 1, 1995·Clinical Transplantation·H C BodenheimerP Sheiner
Oct 1, 1993·Transplantation·H J SchlittR Pichlmayr
Jul 16, 1994·Lancet·P TilstonG Corbitt
Apr 1, 1994·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·W J SandbornR H Wiesner
Mar 3, 1994·The New England Journal of Medicine·H J SchlittR Pichlmayr
Jun 1, 1993·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·P DonaldsonR Williams
Jun 1, 1993·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·T E StarzlJ J Fung
Dec 1, 1996·Immunology Today·K Wood, D H Sachs
Jan 27, 1997·Transplantation·G V MazariegosT E Starzl
May 1, 1995·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J DevlinR Williams

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Citations

Aug 8, 1998·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·T WongR Williams
Jul 13, 2002·The Journal of Pathology·Stuart ForbesMalcolm Alison
Mar 19, 2011·Langenbeck's Archives of Surgery·Fred Fändrich
Sep 2, 2011·Journal of Cardiovascular Translational Research·Michael IbrahimMagdi H Yacoub
Mar 12, 2004·Transplantation Proceedings·A P Monaco
May 28, 2005·Transplantation Proceedings·D A Kelly
May 28, 2005·Transplantation Proceedings·R GirlandaN D Heaton
Aug 11, 2001·Transplantation Proceedings·H S TeA L Baker
Oct 22, 2002·Lancet·J G O'GradyUNKNOWN UK and Republic of Ireland Liver Transplant Study Group
May 3, 2003·Transplant Immunology·Sharon CooksonSuzanne Norris
Apr 23, 2002·Journal of Gastroenterology and Hepatology·Sarah Goddard, David H Adams
Apr 20, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Geoffrey W McCaughan
Oct 7, 2006·Current Opinion in Gastroenterology·J H Lefkowitch
Oct 7, 2006·Current Opinion in Gastroenterology·K A Brown, D K Moonka
Aug 15, 2001·Transplantation·M TakatsukiK Tanaka
Jun 27, 2002·Transplantation·Andrew D CloustonElizabeth E Powell
Aug 2, 2005·Journal of Pediatric Gastroenterology and Nutrition·Abdulrahman Al-HussainiAnil Dhawan
Jun 27, 2008·Transplantation·George Mells, James Neuberger
May 6, 2011·Transplantation·G Alex BishopGeoffrey W McCaughan
Jun 13, 2013·Transplantation·Ronald CharlesShiguang Qian
Apr 15, 2004·Gut·J Neuberger
Jul 26, 2008·The Journal of Clinical Investigation·Marc Martínez-LlordellaAlberto Sánchez-Fueyo
Jul 26, 2008·The Journal of Clinical Investigation·Vicki Seyfert-Margolis, Laurence A Turka
May 27, 2010·The Journal of Clinical Investigation·Kenneth A NewellUNKNOWN Immune Tolerance Network ST507 Study Group
Feb 13, 2004·Comparative Hepatology·Zhaoli SunAndrew S Klein
Jul 12, 2002·Drugs·Maria L Raimondo, Andrew K Burroughs
Nov 24, 2007·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·R F GarciaP McMaster
May 17, 2014·World Journal of Gastroenterology : WJG·Alice Tung Wan SongEdson Abdala
Jun 27, 2014·Science Translational Medicine·Felix BohneAlberto Sánchez-Fueyo

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