The Human Immune Response to Cadaveric and Living Donor Liver Allografts.

摘要: The liver is an important contributor to the human immune system and it plays a pivotal role in creation of both immunoreactive tolerogenic conditions. Liver transplantation provides best chance survival for children adults with failure or cancer. With current demand exceeding number transplantable livers from donors following brain death, improved knowledge, technical advances desire prevent avoidable deaths has led organs living, ABO incompatible (ABOi), cardiac death machine based organ preservation acceptable results. graft most well-tolerated, immunological perspective, all solid transplants. Evidence suggests successful cessation immunosuppression possible ~20-40% transplant recipients without mediated injury, state known as "operational tolerance." An free future ambitious but perhaps not unachievable goal. initial response sterile inflammatory process by innate mechanisms relate preservation-reperfusion process. severity this injury influenced factors can have significant consequences. There are minimal experimental studies that delineate differences adaptive various forms allograft. Apart ABOi transplants, antibody hyperacute rejection rare transplant. T-cell common its incidence does differ between living deceased donor grafts. Transplantation first year life results higher rate operational tolerance, possibly due bias toward Th2 cytokines (IL4, IL10) during period. This review further describes understanding allografts highlight areas topic yet be fully understood.