Knechtle S J
Department of Surgery, University of Wisconsin Medical School, Madison 53792-7375, USA.
Semin Gastrointest Dis. 1998 Jul;9(3):126-35.
Although the transplanted human liver is susceptible to rejection with a similar incidence of rejection as seen with renal allografts, the liver enjoys many immunological benefits relative to other transplanted organs. These include relative resistance to antibody-mediated injury, low frequency of chronic rejection, relatively easy reversibility of acute rejection, and even reversibility of chronic rejection. The reasons for the liver's favored status from an immunological perspective are unclear but are perhaps multifactorial. Currently used clinical protocols of immunosuppression for liver transplantation rely principally on the calcineurin inhibitors, cyclosporine and FK-506. Steroid withdrawal at variable periods after liver transplantation is becoming increasingly common. Compared with other organ transplants, relatively few human liver transplants are lost because of rejection. The transplanted liver may be an appropriate target for tolerance studies.
尽管移植的人类肝脏易发生排斥反应，其排斥发生率与肾移植相似，但相对于其他移植器官，肝脏具有许多免疫学优势。这些优势包括对抗体介导损伤的相对抵抗力、慢性排斥反应发生率低、急性排斥反应相对易于逆转，甚至慢性排斥反应也可逆转。从免疫学角度来看，肝脏享有这种有利地位的原因尚不清楚，但可能是多因素的。目前用于肝移植的临床免疫抑制方案主要依赖于钙调神经磷酸酶抑制剂、环孢素和FK-506。肝移植后不同时期停用类固醇的情况越来越普遍。与其他器官移植相比，因排斥反应而丢失的人类肝移植相对较少。移植的肝脏可能是耐受研究的合适靶点。
