Semin Liver Dis 2007; 27(2): 194-213
DOI: 10.1055/s-2007-979471
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

The Liver: A Special Case in Transplantation Tolerance

Volker Benseler1 , 2 , Geoffrey W. McCaughan1 , Hans J. Schlitt2 , G. Alex Bishop3 , David G. Bowen4 , Patrick Bertolino1
  • 1Centenary Institute and AW Morrow Gastroenterology and Liver Centre, Sydney, Australia
  • 2Department of Surgery, University of Regensburg Medical Center, Regensburg, Germany
  • 3Collaborative Transplant Laboratory, Blackburn Building, Sydney University, Australia
  • 4Center for Vaccines and Immunity, Columbus Children's Research Institute, Columbus, Ohio
Further Information

Publication History

Publication Date:
22 May 2007 (online)


Liver transplants are not often rejected in patients weaned from immunosuppression and are spontaneously accepted in some animal models. We review past and recent findings of liver transplantation and propose a unified model in which several mechanisms act in concert to induce and maintain tolerance in both naïve and effector T cell compartments. First, passenger leukocytes migrate to lymphoid tissues and induce apoptosis of alloreactive naïve T cells. Second, antigen-specific activation and subsequent deletion of naïve and effector cells within the liver itself purge the repertoire of alloreactive T cells. Other mechanisms such as microchimerism and migration of donor dendritic cells to the thymus may play a predominant role in maintaining tolerance, and soluble major histocompatibility complex molecules, donor peptides, and regulatory T cells may participate in the induction and maintenance phases. Thus, the major challenge in liver transplantation will be to favor these tolerogenic processes while developing strategies that specifically inhibit alloreactive memory T cells.


Patrick Bertolino
Ph.D. Volker Benseler, M.D. 

AW Morrow Gastroenterology and Liver Centre, Centenary Institute of Cancer Medicine and Cell Biology

Locked Bag No. 6, Newtown 2042, NSW, Australia