Immunometabolic Remodeling in Liver Transplantation: Perspectives and Strategies

02 Apr 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

Liver transplantation remains the definitive treatment for end-stage liver disease, with expanding indications including acute liver failure and transplant oncology. The immunometabolic milieu both systemically and locally in these contexts can diverge from traditional end-stage disease, presenting distinct challenges for immune management. Advances in surgical technique and perioperative care have improved long-term survival, yet extended survival and a larger donor pool have revealed long-term complications such as post-transplant metabolic syndrome.
The patient’s systemic metabolic state influences immune cell energy utilization and immunosuppressant metabolism, adding complexity to management. Post-transplant, immune cell subsets exhibit dynamic adaptations in energy metabolism that influence rejection risk, ischemia-reperfusion injury, and the development of immune tolerance. The review confines its scope to mechanisms of immune cell metabolic remodeling and their implications for transplant outcomes.
It also discusses translational prospects, including targeting immunometabolic pathways to optimize immunosuppressive regimens, mitigate IRI, and identify non-invasive biomarkers for immune monitoring. Where data are uncertain in the source, this uncertainty is acknowledged. These insights aim to inform strategies to improve long-term outcomes in liver transplant recipients.