Collaborative Transplantation Laboratory, Royal Prince Alfred Hospital and the University of Sydney, Australia.
Best Pract Res Clin Gastroenterol. 2012 Feb;26(1):73-84. doi: 10.1016/j.bpg.2012.01.003.
Operational tolerance (OT) in liver transplant patients occurs much more frequently than OT of other transplanted organs; however the rate of OT varies considerably with the centre and patient population. Rates of OT range from 15% of the total liver transplant (LTX) patient population down to less than 5%. This review examines the reports of liver OT and compares the factors that could contribute to this variation. Multiple factors were examined, including the time from transplantation when weaning of immunosuppression (IS) was commenced, the rapidity of weaning, the contribution of maintenance and induction IS and the patient population transplanted. The approaches that might be used to increase the likelihood of OT are discussed and the approaches to monitoring OT in LTX patients are reviewed.
肝移植患者的免疫耐受（Operational tolerance，OT）比其他移植器官的免疫耐受更为常见；然而，免疫耐受的发生率因中心和患者人群而异。免疫耐受的发生率从总肝移植（Liver Transplantation，LTX）患者人群的 15%下降到不足 5%。本综述检查了肝免疫耐受的报告，并比较了可能导致这种变化的因素。检查了多个因素，包括开始免疫抑制（Immunosuppression，IS）脱药的时间、脱药的速度、维持和诱导 IS 的贡献以及移植的患者人群。讨论了可能增加免疫耐受可能性的方法，并回顾了监测 LTX 患者免疫耐受的方法。
