Insights – Tolerance after liver transplantation
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Selected liver transplant recipients can remain without immunosuppressive treatment without immunological damage in the liver graft, achieving the so-called operative liver tolerance. The transplant community has devoted a great deal of research effort in recent decades, conducting multicentre clinical trials and translational studies trying to better understand this phenomenon. Recent studies on the withdrawal of immunosuppressive therapy have revealed some clinical, molecular and histological markers that may predict tolerance. However, a clinical protocol is still required to be used in routine clinical practice.
- Discuss recent findings on histological biomarkers that can predict tolerance after liver transplantation.
- Discuss the use of biomarkers to select patients to be included in clinical trials of tolerance.
- Discuss the results of the latest recent clinical trials and what is the future of such studies.
- Discuss whether it is realistic to have a clinical protocol proposal for minimisation and/or immunosuppressive treatment in clinical practice.
- Introduction – Eliano Bonaccorsi Riani and Roberta Angelico
- Predictive histological markers of tolerance – Anthony Jake Demetris
- Clinical trials to achieve tolerance: Present and Future – Alberto Sanchez-Fueyo
- Q&A moderated by Eliano Bonaccorsi Riani and Roberta Angelico
- Closing Remarks
Anthony Jake Demetris
University of Pittsburgh, Pittsburgh, PA | Dr. Demetris has spent many years working on the histopathology of liver transplantation. He has been fundamental in histological analyses in the most important studies and consensus on tolerance and rejection of liver transplantation. His interests include: 1) immunobiology of tolerance induction and chronic rejection; 2) the role of cytokines in the control of the growth of the biliary epithelium; and 3) digital pathology to improve liver and transplant pathology and research.
Institute of Liver Studies, King's College London - Honorary Consultant at King's College Hospital | Alberto Sánchez-Fueyo MD PhD, is Professor of Hepatology, Academic Head of the Institute of Liver Studies at King’s College London, and Honorary Transplant Hepatology Consultant at King’s College Hospital. His research has focused on understanding the mechanisms of immunological tolerance in transplantation and developing novel immunomodulatory therapies, for which he has received funding from MRC, NIHR, NIH and EU, among others. He has recently conducted important multi centric clinical trials on immunosuppression treatment withdrawal aiming to achieve operational liver tolerance.
Eliano Bonaccorsi Riani
Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Bruxelles, Belgium | Dr Eliano Bonaccorsi-Riani is a Liver Transplant Surgeon at the Liver Transplant Unit at Cliniques Universitaires Saint-Luc (CUSL), Université Catholique de Louvain (UCL) in Brussels, Belgium. He has an active role in the Living Donor Liver Transplant Program of this institution. His research interest focuses on the tolerance and rejection biomarkers in liver transplantation. Dr. Bonaccorsi-Riani is also a senior investigator at the Pôle de Chirurgie Expérimentale et Transplantation at the Institute de Recherche Clinique (UCL).
Senior Lecturer and consultant surgeon, HPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Rome, Italy | Roberta Angelico, MD, PhD, FEBS Dr Angelico has been trained in General Surgery at the University of Rome Tor Vergata, Rome, Italy where in 2018, she obtained the degree of PhD in Organ Transplantation and since 2019, she has been working as consultant surgeon and senior lecturer in the Liver and Kidney Transplant Unit. From 2014 to 2016 she worked as senior fellow in the Liver Unit of the Queen Elizabeth Hospital of Birmingham, UK. From 2016 to 2019 Dr Angelico worked as transplant surgeon in the Paediatric Liver and Kidney Transplant Centre of the Bambino Gesù Children’s Hospital, Rome, Italy.