Tolerogenic Mechanisms in Liver Transplantation

incidence of rejection compared with other solid organs, and spontaneous acceptance of the liver graft with successful discontinuation of immunosuppression has been reported in nearly 20% of LT recipients [10,11]. Multiple studies have suggested the protective effect of the liver allograft in Simultaneous Liver-Kidney Transplantation (SLKT) compared with recipients of isolated renal transplants; SLKT recipients demonstrate a lower frequency of kidney rejection as well as improved long-term survival [12-14]. Among sensitized kidney transplant recipients with positive lymphocytotoxic crossmatches, inclusion of the liver graft reverted the crossmatch to negative within 1 hour of reperfusion, and prevented the occurrence of hyperacute rejection [15,16]. The protective effect of simultaneous LT extends to other solid organ grafts, as the observed incidence of intestinal allograft rejection is reduced in combined liver-intestine transplant recipients [17].