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World J Transplant. Mar 18, 2024; 14(1): 89772
Published online Mar 18, 2024. doi: 10.5500/wjt.v14.i1.89772
Immunology demystified: A guide for transplant hepatologists
Iva Kosuta, Tomislav Kelava, Ana Ostojic, Vibor Sesa, Anna Mrzljak, Hrvoje Lalic
Iva Kosuta, Department of Intensive Care Medicine, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Tomislav Kelava, Department of Physiology, School of Medicine, Univeristy of Zagreb, Zagreb 10000, Croatia
Tomislav Kelava, Laboratory for Molecular Immunology, Croatian Institute for Brain Research, Zagreb 10000, Croatia
Ana Ostojic, Vibor Sesa, Department of Gastroenterology and Hepatology, Liver Transplant Center, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Anna Mrzljak, Department of Medicine, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Hrvoje Lalic, Department of Physiology, University of Zagreb School of Medicine, Zagreb 10000, Croatia
Hrvoje Lalic, Laboratory for Cell Biology, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb 10000, Croatia
Hrvoje Lalic, Department of Laboratory Immunology, Clinical Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb 10000, Croatia
Author contributions: Kosuta I contributed to the literature review, data analysis, interpretation, and the initial manuscript draft; Kelava T, Ostojic A, and Mrzljak A were responsible for data collection and drafting the preliminary manuscript; Lalic H played a key role in conceptualizing and designing the manuscript, critically revising the initial draft, and granting final approval for the article; All authors have given their approval for the final version of the manuscript.
Conflict-of-interest statement: None of the authors, including the first author, have potential conflicts-of-interest (financial, professional, or personal) that are relevant to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Iva Kosuta, PhD, Chief Physician, Department of Intensive Care Medicine, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia. ivakosuta@gmail.com
Received: November 12, 2023
Peer-review started: November 12, 2023
First decision: January 2, 2024
Revised: January 24, 2024
Accepted: February 29, 2024
Article in press: February 29, 2024
Published online: March 18, 2024
Processing time: 123 Days and 20.8 Hours
Core Tip

Core Tip: Liver transplantation is standard practice for treating end-stage liver disease, requiring effective immunosuppressive medications to regulate the recipient's immune response. In the post-transplant period, vigilance is necessary to recognize and manage various rejection types (T-cell-mediated, antibody-mediated, and chronic rejection). As the majority of patients require lifelong immunosuppression while the mechanisms of operational tolerance are still being explored, healthcare providers must possess a solid understanding of immune responses, rejection mechanisms, and the targets of immunosuppressive drugs. Despite the absence of consensus on an ideal immunosuppressive regimen, customization remain crucial.