Title : Patient immunologic endotypes of ischemia-reperfusion injury in liver transplantation
Abstract:
Solid organ transplantation is the best therapeutic choice for patients with end stage organ failure. Ischemia-reperfusion injury (IRI) is an unavoidable consequence of the processes of organ recovery and implantation and represents a major risk factor for allograft rejection. The harmful effects of parenchymal cell damage to the donor organ coupled with the restoration of blood flow from an unhealthy recipient seen in IRI involves complex interactions between the innate and adaptive immune systems. However, no clinical therapeutics or patient-specific diagnostics are widely available. Etiologies leading to LT are heterogeneous, and only ~50% of OLT recipients experience significant IRI despite similar immunosuppression regimens. Genetic susceptibility to IRI is unknown, and rates of progression differ markedly, as do post-transplant liver function and patient and allograft outcomes. This presentation will provide current knowledge of associations between inflammatory endotypes and clinical presentations in LT-IRI.
Audience Take Away Notes:
• The basics of ischemia-reperfusion injury (IRI) terminology and the role it can play in transplant recipient outcomes.
• Recent advances in our understanding of the molecular mechanisms and immune pathways involved in ischemia-reperfusion injury in liver and other organs.
• Different patient immune endotypes that lead to either tolerance against, or increased susceptibility to, injury and downstream alloimmune responses and deleterious outcomes in liver transplantation.
• This lecture is intended to provide current information regarding potential therapeutic approaches during liver transplantation surgery to mitigate the effects of IRI, as well as diagnostic tools to aid in the identification of patients who are more or less likely to require IRI mitigation strategies based on their specific immune endotypes
