The most common reason for liver transplantation in adults is cirrhosis which can be caused by many different types of liver damage: viruses such as hepatitis B and C, alcohol, autoimmune liver diseases, buildup of fat in the liver, and hereditary liver diseases.
Liver transplantation represents 23% of all organs transplanted. In 2008, 90,000 recipients were living with a liver graft (EU and US) and 100,000 to 180,000 people are expected to be living with a liver graft in 2015 (EU and US). >50% of liver transplant patients are HCV+.
Liver Transplant Recipients are treated with strong immunosuppressive drugs treatment, like Calcineurin Inhibitor (CNI). The long-term survival of transplanted grafts essentially depends on the life-long administration of these immunosuppressive drugs to prevent graft rejection. These drugs are highly effective in preventing graft rejection but they are also associated with severe side effects, such as nephrotoxicity, increased risk of opportunistic infections and tumors and metabolic complications such as diabetes, hyperlipidemia and arterial hypertension. In addition, all HCV+ recipients will experience HCV rebound caused by CNI. Due to the side effects of immunosuppressive drugs, the induction of tolerance, defined as a state in which the graft maintains a normal function in the absence of chronic immunosuppression, is one of the main goals of research in transplant immunology.
Liver Tolerance Diagnostic / L-TolX
In liver transplantation, complete immunosuppression withdrawal can be achieved in approximately 20% of patients. However, accurate identification of these recipients remains a challenge.
The L-TolX test is a qualitative diagnostic test service using the gene expression profiling of mRNA. The L-TolX test is an in vitro diagnostic test intended to aid in the identification of liver transplant recipients with stable allograft function for whom immunosuppression withdrawal is being considered.