Maddur Haripriya, Wilson Nicole, Patil Pallavi, Asrani Sumeet
University of Arizona, Tucson, AZ, USA.
Baylor University Medical Center Dallas, USA.
J Clin Exp Hepatol. 2024 Jul-Aug;14(4):101363. doi: 10.1016/j.jceh.2024.101363. Epub 2024 Feb 22.
Rejection following liver transplantation continues to impact transplant recipients although rates have decreased over time with advances in immunosuppression management. The diagnosis of rejection remains challenging with liver biopsy remaining the reference standard for diagnosis. Proper classification of rejection type and severity is imperative as this guides management and ultimately graft preservation. Future areas of promise include non-invasive testing for detection of rejection to reduce the morbidity associated with invasive testing and further advances in immunosuppression management to reduce toxicities associated with immunosuppression while minimizing rejection related morbidity.
尽管随着免疫抑制管理的进步,肝移植后的排斥反应发生率随时间有所下降,但仍继续影响着移植受者。排斥反应的诊断仍然具有挑战性,肝活检仍是诊断的参考标准。正确分类排斥反应的类型和严重程度至关重要,因为这指导着治疗并最终关乎移植物的保存。未来有前景的领域包括用于检测排斥反应的非侵入性检测,以降低与侵入性检测相关的发病率,以及免疫抑制管理的进一步进展,以降低与免疫抑制相关的毒性,同时将与排斥反应相关的发病率降至最低。