Page 21 - MemoriaEHD-Eng

www.ciberehd.org

P4. Hepatic Immunology, Cell Therapy and Transplant

Coordinator:

Miquel Navasa

Assistant Coordinator:

Marina Berenguer

Despite the fact that Program 4 covers various topics, its primary area of research
Description
is liver transplant. About 15,000 liver transplants are performed worldwide every

year today. Transplant recipient survival rates are satisfactory. Survival is about
90% 1 year after the transplant, about 75% after 5 years, and 65% after 10 years.

Nevertheless, liver transplant still presents a series of important clinical problems:

Immunosuppression: a) must be optimized to adapt to the needs of each patient
in order to reduce the risk of rejection and of toxicity; b) the possibility of com-

pletely withdrawing immunosuppression in patients showing graft tolerance, who

may represent a considerable proportion of transplant patients several years after
the transplant, and c) suitably detecting and handling complications resulting from

immunosuppressants. These aspects must be investigated in Program 4.

Pre-transplant disease recurrence, particularly hepatitis C. The importance of he-

patitis C recurrence is on one hand based on the high number of patients receiving
transplant due to liver diseases relating to the hepatitis C virus , and on the other

hand the huge negative impact of hepatitis C recurrence on post-transplant survi-
val due to the rapid progression of the hepatic lesion in the graft in a considerable

proportion of transplant patients. The lesion mechanisms in hepatitis C recurrence

and therapeutic management of patients with this complication constitute lines of
research that are of great interest today, particularly in the current context of deve-

loping and marketing strong new viral agents. Program 4 therefore also preferably 13
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takes care of the research for this problem.
T
OR
Disproportion between the number of organ donors and the number of patients P
on a liver transplant wait list. Therefore, over the past few years, on one hand a RE
L
series of actions that sought to palliate this problem were implemented by means A
of investigating strategies that allow increasing the number of liver grafts suitable NU
N
for transplant, and on the other hand, improvements were made in managing the A
D /
transplant wait list. These aspects are also grounds for research for Program 4 H
groups.
E
ER
There were three relevant aspects in 2013 that brought about important results: IB
C
The research group established new therapeutic action targets based on adipocyto-
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kine modulation both in liver resections and liver transplant in marginal organs,