IMMUNOLOGICAL PROBLEMS IN LIVER TRANSPLANTATION

Liver transplantation – a life-saving surgical procedure in end-stage liver diseases. However, post-transplant immunological issues — namely the recipient’s immune responses developing against the transplanted liver cells — remain one of the limiting factors for transplantation success. This article analyses the immunological basis of liver transplantation, the organ’s immunological “specificity”, immunocompetent escort cells and cell types, types of immune responses (acute, delayed, memory); the immunological problems arising between the recipient and the transplanted cells (for example, graft rejection, donor-versus-recipient cell immune reactions, infections under immunosuppression). At the same time, the principles of immunosuppressive therapy, current strategies and new approaches aimed at overcoming immunological problems are discussed. The article also covers the microbiology perspective — for example, infection development in liver transplantation, microbiological monitoring under immunosuppression and immunological interactions with microbes.