Ann Liver Transplant.  2022 May;2(1):1-7. 10.52604/alt.22.0003.

Future-directed studies on immunosuppressive treatments and xenografts for organ transplantation

• Park JI
• Jung BH

• KMID: 2560874
• DOI: http://doi.org/10.52604/alt.22.0003

Abstract

Marked development has led to significant improvements in the outcomes of organ transplantation. With the development of surgical techniques and immunosuppression, organ transplantation has become the ultimate treatment for patients with end-stage organ failure. Although the short-term transplant results have been improved, long-term outcomes of organ transplantation seem to have reached its limit. Posttransplant immunosuppression is directed toward optimization of the immunosuppressive regimens with conventional immunosuppressive agents for better control of antibodies while avoiding calcineurin inhibitor toxicity and by biological therapeutics including co-stimulation blockade agents that provide effective control of antibodies along with a reduction in the use or avoidance of available immunosuppressive agents. Tolerance induction through transplantation of donor hematopoietic stem cells or infusion of regulatory cells using various sources of immune cells is also a promising strategy because it can lead to avoidance of immunosuppressant-associated complications. Recent results of new immunosuppressants obtained from non-human study models provide valuable information on the optimization of immunosuppressive regimens. The recent initial success of human xenotransplantation using pig kidneys and hearts will give a new insight toward xenotransplantation. All new immunosuppressants and regimens should be validated under the considerations for risk-benefit balance in various clinical conditions. Future immunosuppressive therapy strategies are needed to effectively control antibodies and antibody-mediated rejection while avoiding calcineurin inhibitor-associated complications.

Keyword

Organ transplantation; Immunosuppressive agents; Co-stimulatory pathway; Immune checkpoint; Xenotransplantation