New approaches to immunosuppression in liver transplantation

Sarah Goddard, David Adams

Research output: Contribution to journalReview article

15 Citations (Scopus)


With the continued improvements in outcome following liver transplantation, the drawbacks associated with conventional immunosuppression regimens become increasingly apparent. Although up to 70% of patients develop a histological infiltrate of the graft (acute rejection), many of these will resolve spontaneously, and chronic rejection is rare. If a robust form of allograft acceptance or tolerance can be established, then immunosuppression can be withdrawn along with all the accompanying risks. The liver is already known to be associated with downregulated immune responses; the mechanism for this is unclear, but may be related to a number of mechanisms known to be involved in peripheral tolerance. There are many strategies being studied for achieving allograft tolerance, including the use of modern immunosuppressants, antibodies that target key molecules in the immune response, and recruitment of leukocytes to allografts. In the interim, it is necessary to look for safe protocols that allow trials of tolerance strategies without putting patients at increased risk.
Original languageEnglish
Pages (from-to)116-126
Number of pages11
JournalJournal of Gastroenterology and Hepatology
Issue number2
Publication statusPublished - 1 Feb 2002


  • immunosuppression
  • transplantation
  • liver
  • immunological tolerance
  • graft rejection


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