After ten years of work, an international research team led by the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) has identified molecular signatures that could help diagnose chronic rejection after liver transplants. The results were published in the Journal of Hepatology and could revolutionize transplantation medicine.

Liver transplants save many seriously ill patients, but the risk of rejection remains. Acute and chronic forms differ significantly. Acute rejection, in which immune cells attack the donor liver liver and increase liver values, can be detected relatively well and treated with adapted immunosuppression or cortisone, with a low risk of permanent damage. Chronic rejection, on the other hand, triggered by antibody attacks on the blood vessels of the liver, often goes unnoticed, shows no abnormal laboratory values and leads to scarring in up to 50 percent of cases, which can result in liver cirrhosis or a new transplant. Currently, it is only diagnosed by microscopic tissue samples, which is difficult and inaccurate.

The research team analysed over 158 tissue samples from patients from Hannover and Barcelona to investigate the activity of genes, cytokines, complement factors and the extracellular matrix. They were able to identify typical molecular patterns that distinguish acute and chronic rejection from each other. In particular, signaling pathways such as TNF-NF-κB, which lead to scarring, and complement activation as part of the innate immune response are considered indicators of chronic rejection.

These findings could revolutionize diagnosis by making it possible to detect chronic rejections earlier and more precisely in surveillance biopsies. This would enable more targeted therapy with immunosuppressants or antibody-lowering measures such as plasmapheresis. The research is considered an important step towards personalized medicine, with the aim of offering patients individually optimized treatment and extending the lifespan of the transplanted organ.

Original Paper:

Molecular signatures discriminating different types of rejection in human liver transplants – ScienceDirect

Editor: X-Press Journalistenbüro GbR

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