Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 2330, Chicago, IL 60611, USA.
Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron St. Chicago, IL 60611, USA.
Clin Liver Dis. 2021 Feb;25(1):53-72. doi: 10.1016/j.cld.2020.08.003. Epub 2020 Oct 26.
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.
肝移植受者的生存延长将排斥反应管理推向了肝移植研究的前沿。本文讨论了 T 细胞介导的排斥反应、抗体介导的排斥反应和慢性排斥反应。我们重点讨论了预防，然后讨论了治疗选择。排斥反应管理的未来方向包括排斥反应的生物标志物，这可能允许监测被认为排斥反应风险高的患者，并在出现任何临床证据之前检测排斥反应，以提高移植物和患者的存活率。随着肝移植受者移植物寿命和存活率的提高，排斥反应管理的新前沿侧重于最小化、撤药和个体化免疫抑制。
