Requirement of Protocol Biopsy Before and After Complete Cessation of Immunosuppression After Liver Transplantation

• DOI: 10.1097/tp.0b013e318195a7cb
• Publication Date: 2010-01-27T06:30:35Z
• Authors: Mami Yoshitomi; Takaaki Koshiba; Hironori Haga; Ying Li; Xiangdong Zhao; Donghua Cheng; Aya Miyagawa; Hiromi Sakashita; Tatsuaki Tsuruyama; Hidenori Ohe; Mikiko Ueda; Shinya Okamoto; Hiroto Egawa; Kathryn Wood; Shimon Sakaguchi; Toshiaki Manabe; Koichi Tanaka; Shinji Uemoto
• Keywords: Immunosuppression; Hepatic fibrosis

Background. Operational tolerance is defined as long-term acceptance of a transplanted organ after complete cessation immunosuppression (IS), but may not always protect against antigen-dependent changes in graft morphology. Method. IS free patients living-donor liver transplantation (LDLT) underwent protocol biopsy (tolerance group [Gr-Tol]) and were evaluated for rejection fibrosis. The degree fibrosis was compared with those the on maintenance (Gr-IS) base line normal (Gr-BS). When bridging or progression observed, reintroduced increased Gr-Tol weaning process. Results. Neither acute nor chronic observed. fibrosis, however, significantly greater than Gr-IS Gr-BS. In Gr-Tol, number infiltrating FOXP3+ cells increased, interval between LDLT plus donor age longer, recipient at younger, Gr-IS. However, none these three parameters correlated 7 11 whom improvement observed by subsequent biopsy. Conclusion. Grafts operationally tolerant did exhibit rejection, they exhibited It remains elusive whether grafts antigen dependent. finding that reintroduction increase improved supported possibility