Pan Qi, Zhou Aiwei, Wang Bingran, Xiao Wanglong, Gao Yunmu, Liu Hongyuan, Song Jiaqi, Liu Yongbo, Liu Yuan, Xia Qiang
Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Engineering Research Center of Transplantation and Immunology, Shanghai, China.
Int J Surg. 2025 Jun 1;111(6):3908-3919. doi: 10.1097/JS9.0000000000002358. Epub 2025 Apr 3.
Liver transplantation serves as a vital therapeutic intervention for individuals suffering from end-stage liver disease globally. A significant complication encountered by liver transplant recipients during the postoperative period is acute rejection, which has traditionally been identified through invasive graft biopsy procedures. Furthermore, assessing the immune status of liver transplant patients is essential for effective posttransplant management and represents a significant advancement toward the personalization of immunosuppressive therapy. Nevertheless, current immunological monitoring after the transplantation predominantly depends on clinical judgment and the measurement of immunosuppressive drug levels, lacking a comprehensive evaluation of actual immune system suppression. In contrast, biomarkers offer a comparatively novel and safer approach for the detection and prediction of transplant rejection, though their clinical application remains constrained due to the absence of prospective validation studies. This review examines the existing literature on potential biomarkers for acute rejection following liver transplantation, and their implications for clinical decision-making.
肝移植是全球终末期肝病患者至关重要的治疗手段。肝移植受者术后面临的一个重大并发症是急性排斥反应，传统上通过侵入性的移植肝活检程序来识别。此外，评估肝移植患者的免疫状态对于有效的移植后管理至关重要，并且代表了免疫抑制治疗个体化方面的重大进展。然而，目前移植后的免疫监测主要依赖临床判断和免疫抑制药物水平的测定，缺乏对实际免疫系统抑制的全面评估。相比之下，生物标志物为检测和预测移植排斥反应提供了一种相对新颖且更安全的方法，尽管由于缺乏前瞻性验证研究，其临床应用仍然受到限制。本综述探讨了关于肝移植后急性排斥反应潜在生物标志物的现有文献及其对临床决策的影响。
