Advances in Rejection Management: Prevention and Treatment

Clin Liver Dis. 2021 Feb;25(1):53-72. doi: 10.1016/j.cld.2020.08.003. Epub 2020 Oct 26.

Abstract

Extended survival of liver transplant recipients has brought rejection management to the forefront of liver transplant research. This article discusses T-cell-mediated rejection, antibody-mediated rejection, and chronic rejection. We focus on the prevention and then discuss treatment options. Future directions of rejection management include biomarkers of rejection, which may allow for monitoring of patients who are considered high risk for rejection and detection of rejection before there is any clinical evidence to improve graft and patient survival. With improved graft life and survival of liver transplant recipients, the new frontier of rejection management focuses on immunosuppression minimization, withdrawal, and personalization.

Keywords: Antibody-mediated rejection; Biomarkers of rejection; Immunosuppression minimization; T-cell mediated rejection; Tolerance.

Publication types

  • Review

MeSH terms

  • Graft Rejection* / prevention & control
  • Graft Survival
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation*
  • T-Lymphocytes

Substances

  • Immunosuppressive Agents