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摘要: 肝移植是治疗各类型终末期肝病的重要手段。得益于过去30年间免疫抑制剂应用的进展,肝移植患者获得良好的近期治疗效果。然而,近年来临床证据表明,包括肾功能损伤、代谢综合征和原发病复发在内的免疫抑制剂相关不良反应,成为影响肝移植远期疗效的重要因素。供体特异性免疫耐受被认为是器官移植术后最理想的免疫状态,能够有效减少甚至摆脱免疫抑制剂的应用。肝脏是体内特殊的免疫赦免器官,免疫耐受研究在肝移植领域具有广阔的前景。本文总结了近年来肝移植免疫耐受的研究进展,并对今后研究的发展方向进行展望。
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[1] Starzl TE, Demetris AJ, Trucco M, et al. Cell migration and chimerism after whole-organ transplantation:the basis of graft acceptance[J]. Hepatology, 1993, 17(6):1127-1152. doi: 10.1002/(ISSN)1527-3350 [2] Devlin J, Doherty D, Thomson L, et al. Defining the outcome of immunosuppression withdrawal after liver transplantation[J]. Hepatology, 1998, 27(4):926-933. doi: 10.1002/(ISSN)1527-3350 [3] Feng S, Ekong UD, Lobritto SJ, et al. Complete immunosuppression withdrawal and subsequent allograft function among pediatric recipients of parental living donor liver transplants[J]. JAMA, 2012, 307(3):283-293. DOI: 10.1001/jama.2011.2014. [4] Benítez C, Londoño MC, Miquel R, et al. Prospective multicenter clinical trial of immunosuppressive drug withdrawal in stable adult liver transplant recipients[J]. Hepatology, 2013, 58(5):1824-1835. DOI: 10.1002/hep.26426. [5] Bohne F, Martínez-Llordella M, Lozano JJ, et al. Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation[J]. J Clin Invest, 2012, 122(1):368-382. DOI 10.1172/JCI59411. doi: 10.1172/JCI59411 [6] Calne RY. Prope tolerance:a step in the search for tolerance in the clinic[J]. World J Surg, 2000, 24(7):793-796. doi: 10.1007/s002680010127 [7] Donckier V, Craciun L, Miqueu P, et al. Expansion of memory-type CD8+ T cells correlates with the failure of early immunosuppression withdrawal after cadaver liver transplantation using high-dose ATG induction and rapamycin[J]. Transplantation, 2013, 96(3):306-315. DOI: 10.1097/TP.0b013e3182985414. [8] Benítez CE, Puig-Pey I, López M, et al. ATG-Fresenius treatment and low-dose tacrolimus:results of a randomized controlled trial in liver transplantation[J]. Am J Transplant, 2010, 10(10):2296-2304. DOI: 10.1111/j.1600-6143.2010.03164.x. [9] Donckier V, Craciun L, Lucidi V, et al. Acute liver transplant rejection upon immunosuppression withdrawal in a tolerance induction trial:potential role of IFN-gamma-secreting CD8+ T cells[J]. Transplantation, 2009, 87(9 Suppl):S91-S95. DOI: 10.1097/TP.0b013e3181a2dee6. [10] Tan J, Wu W, Xu X, et al. Induction therapy with autologous mesenchymal stem cells in living-related kidney transplants:a randomized controlled trial[J]. JAMA, 2012, 307(11):1169-1177. DOI: 10.1001/jama.2012.316.
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