The goal of this clinical trial is to learn whether liver parenchyma chimerism can represent a chievement of operational tolerance in liver transplantation recipients. The researchers will examine the degree of parenchyma chimerism. The participants will withdraw or minimize their immunosuppression to avoid the adverse effects of immunosuppressants.
Inclusion Criteria:
a. The patients had liver transplantation, either deceased liver or liver donor, for ≥ 5 years.
b. Age ≥ 20 years old. c. The patients have stable liver function, and do not have clinical suspicious of acute cell-mediated rejection within 1 year.
d. Sign the informed consent. e. Platelet ≥ 80000/mm3. f. INR ≤ 1.4 g. AST and ALT ≤ 1.5X h. Albumin ≥ 3.5gm/dl. i. Total bilirubin < 1.5mg/dl. j. ECOG ≤ 2
Exclusion Criteria:
All enrolled liver transplant recipients will undergo a liver biopsy for STR analysis. Based on the degree of chimerism found, patients will proceed to either an immunosuppression withdrawal protocol (if STR $\\ge$ 75% percentile cutoff) or an immunosuppression minimization protocol (if STR \> 15% but \< 75% percentile).
Taoyuan, 333, Taiwan
Efficacy and Safety of Immunosuppressive Withdrawal After Pediatric Liver Transplantation
Withdrawal of Immunosuppression in Long Term Stable Liver Transplant Recipients
Assessment Of the Safety and Benefit of Prospective Immunosuppressive Drug Withdrawal in Liver Transplantation and Prediction of Operational Tolerance
Using T-Cell Alloreactivity and Chimerism to Guide Immunosuppression Minimization in Intestinal Transplantation
Pilot Study of Immunosuppression Drug Weaning in Liver Recipients Exhibiting Biomarkers of High Likelihood of Tolerance
Gradual Withdrawal of Immune System Suppressing Drugs in Patients Receiving a Liver Transplant
Withdrawal of Immunosuppression in Pediatric Liver Transplant Recipients
Liver Immune Tolerance Marker Utilization Study