Operational tolerance after liver transplantation

摘要: The achievement of an immunosuppression (IS)-free state after transplantation represents the ultimate goal any immunosuppressive regimen. While clinical operational tolerance (COT) remains exception other types solid organ transplantation, several cases COT have been described liver (LT). Overall, experience gained so far worldwide demonstrates that can be achieved safely in one quarter selected individuals, irrespective immunological background donor and recipient, patient age, indication for LT, study endpoint, length weaning period pre/post-weaning follow-up, presence or not chimerism. However, most transplant physicians still believe is out reach majority LT recipients because potential risk survival, non-randomized nature studies reported far, selective patients enrolled such studies, making them non-representative whole population recipients. Despite these concerns, present article this attitude potentially no longer justified, given growing evidence a permanent stable IS-free proportion individuals who received non-immune mediated diseases.