Conversion of Pancreas Allograft Rejection to Acceptance by Liver Transplantation1

Wang, Chuanmin; Sun, Junhong; Li, Li; Wang, Lisheng; Dolan, Paul; Sheil, A. G. R.

doi:10.1097/00007890-199801270-00007

Cited by 38 publications

(22 citation statements)

References 16 publications

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“…9 This spontaneous acceptance of a transplanted liver occurs in a wide range of mammalian species, including all mouse strains tested, 10 many low-responder rat strains, 11 outbred pigs, 9 and primates. 9 Even more surprising is the reversal of heart 12 or pancreas 13 transplant rejection by a liver transplant. Transplanted livers can thus act like an immunosuppressive drug in reversing ongoing rejection of other organs.…”

Section: The Phenomenon Of Spontaneous Liver Allograft Tolerancementioning

confidence: 99%

Immune activation is required for the induction of liver allograft tolerance: Implications for immunosuppressive therapy

Bishop

McCaughan

2001

Liver Transpl

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Liver transplants in many animal models are unusual because often they are not rejected even when transplanted across complete major histocompatibility complex barriers without immunosuppression. Their paradoxical behavior is even more obvious when the immune mechanism of acceptance is examined. Instead of acceptance resulting from a lack of immune response to the graft, the opposite occurs, and there is an unusual extensive increase in immune activation in acceptance compared with rejection. This abnormal extensive immune activation is driven by

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Section: The Phenomenon Of Spontaneous Liver Allograft Tolerancementioning

confidence: 99%

Immune activation is required for the induction of liver allograft tolerance: Implications for immunosuppressive therapy

Bishop

McCaughan

2001

Liver Transpl

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“…However, a well-established benefit of transplanting the liver in combination with another organ is the ability of the liver to protect accompanying organs against rejection (30)(31)(32). This protective effect has been documented experimentally after combined liver plus pancreas transplantation in rodents (33,34). Clinically, the immunoprotective effect of the liver allograft on the concommitantly transplanted pancreas and intestine (in multivisceral and liver/intestine recipients) was clearly demonstrated by Abu-Elmagd et al (35,36).…”

Section: Discussionmentioning

confidence: 99%

Combined ‘En Bloc’ Liver and Pancreas Transplantation in Patients with Liver Disease and Type 1 Diabetes Mellitus

Pirenne¹,

Deloose²,

Coosemans³

et al. 2004

American Journal of Transplantation

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Liver disease alters the glucose metabolism and may cause diabetes, but this condition is potentially reversible with liver transplantation (LTx). Type 1 diabetes mellitus may be coincidentally present in a LTx candidate and immunosuppressive drugs will aggravate diabetes and make its management more difficult for posttransplant. In addition, diabetes negatively influences outcome after LTx. Therefore, the question arises as to why not transplanting the pancreas in addition to the liver in selected patients suffering from both liver disease and Type 1 diabetes. We report two cases of en bloc combined liver and pancreatic transplantation, a technique originally described a decade ago in the treatment of upper abdominal malignancies but rarely used for the treatment of combined liver disease and Type 1 diabetes. Both recipients are currently liver disease-free and insulin-free more than 2 and 4 years posttransplant, respectively. Surgical, medical and immunological aspects of combined liver-pancreas transplantation are discussed in the light of the existing relevant literature.

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“…Liver transplants were also able to reverse severe ongoing rejection of previous organ transplants from the same strain, including heart [2], pancreas [3] and skin [4,5,17]. Liver transplants could reverse ongoing rejection even 6 days after transplantation of the heart, but only in 50% of cases, while both organs were rejected when the liver was transplanted after 6 days [26], indicating that there was an ‘all-or-nothing’ threshold between rejection and acceptance.…”

Section: Liver Transplantation Is Associated With the Induction Of Tomentioning

confidence: 99%

“…Liver transplants can also reverse ongoing rejection of previous organ allografts from the same donor strain, including heart [2], pancreas [3] and skin [4,5]. …”

Section: Introductionmentioning

confidence: 99%

Role of the Hepatic Parenchyma in Liver Transplant Tolerance: A Paradigm Revisited

Benseler

Tay

Bowen

et al. 2011

Dig Dis

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Unlike other solid organs, liver transplants are spontaneously accepted in a wide range of animal models. In the clinic, transplanted livers also display privileged immunological properties allowing weaning of immunosuppression therapy in up to 20% of selected patients. To explain this phenomenon, many studies have focused on the role of donor-derived ‘passenger’ leukocytes that are thought to induce antigen-specific tolerance by migrating from the graft into recipient secondary lymphoid tissues. Although convincing evidence exists that these cells are able to elicit antiallograft T cell hyporesponsiveness, several studies argue against an exclusive role for this cell population and even question whether it is critical in conferring donor MHC-specific tolerance. Instead, these studies suggest that the hepatic parenchyma plays a more critical role in this phenomenon. In this review we will reinterpret the results of old and more recent literature in light of recent advances in the field of liver immunology to explain the contribution of both passenger leukocytes and liver tissue in the liver tolerance effect.

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Conversion of Pancreas Allograft Rejection to Acceptance by Liver Transplantation1

Cited by 38 publications

References 16 publications

Immune activation is required for the induction of liver allograft tolerance: Implications for immunosuppressive therapy

Immune activation is required for the induction of liver allograft tolerance: Implications for immunosuppressive therapy

Combined ‘En Bloc’ Liver and Pancreas Transplantation in Patients with Liver Disease and Type 1 Diabetes Mellitus

Role of the Hepatic Parenchyma in Liver Transplant Tolerance: A Paradigm Revisited

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