Immunosuppression : Trends and Tolerance? - 10/07/14

Doi : 10.1016/j.cld.2014.05.012

Paige M. Porrett, MD, PhD ^a, Sohaib K. Hashmi, BS ^b, Abraham Shaked, MD, PhD ^c,^⁎
^a Division of Liver Transplantation, Department of Surgery, The University of Pennsylvania, 3400 Spruce Street, One Founders Pavilion, Philadelphia, PA 19104, USA
^b Department of Surgery, The University of Pennsylvania, 3400 Spruce Street, Two Dulles Pavilion, Philadelphia, PA 19104, USA
^c Division of Liver Transplantation, Department of Surgery, Penn Transplant Institute, The University of Pennsylvania, 3400 Spruce Street, Two Dulles Pavilion, Philadelphia, PA 19104, USA

^∗Corresponding author.

Résumé

Advances in pharmacologic immunosuppression are responsible for the excellent outcomes experienced by recipients of liver transplants. However, long-term follow-up of these patients reveals an increasing burden of morbidity and mortality that is attributable to these drugs. The authors summarize the agents used in contemporary liver transplantation immunosuppression protocols and discuss the emerging trend within the community to minimize or eliminate these agents from use. The authors present recently published data that may provide the foundation for immunosuppression minimization or tolerance induction in the future and review studies that have focused on the utility of biomarkers in guiding immunosuppression management.

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Keywords : Immunosuppression, Minimization, Tolerance, Biomarkers