Role of toll-like receptors in liver transplantation

Authors

  • Jessica Howell,

    Corresponding author
    1. Liver Transplant Unit, Austin Hospital, Melbourne, Australia
    2. Department of Medicine, University of Melbourne, Melbourne, Australia
    • Address reprint requests to Jessica Howell, MBBS (Hons) PhD, Liver Transplant Unit, Austin Hospital, Studley Road, Heidelberg 3084, Melbourne, Victoria, Australia. Telephone: 61 3 94965000; FAX: 61 3 94963487; E-mail: Jess.Howell@austin.org.au

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  • Paul Gow,

    1. Liver Transplant Unit, Austin Hospital, Melbourne, Australia
    2. Department of Medicine, University of Melbourne, Melbourne, Australia
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  • Peter Angus,

    1. Liver Transplant Unit, Austin Hospital, Melbourne, Australia
    2. Department of Medicine, University of Melbourne, Melbourne, Australia
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  • Kumar Visvanathan

    1. Department of Medicine, University of Melbourne, Melbourne, Australia
    2. Immunology Reasearch Centre, St Vincent's Hospital, Melbourne, Australia
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  • None of the authors have any disclosures to make that are relevant to this study or article.

  • Jessica Howell received scholarship funds for a stipend from the Gastroenterological Society of Australia.

Abstract

Toll-like receptors (TLRs) are pathogen recognition receptors that orchestrate the innate immune response and the subsequent adaptive immune response. TLRs can be triggered by exogenous ligands expressed by invading pathogens or by the release of endogenous ligands, such as that occurring through cellular injury during the transplantation process. They are now recognized to play an important role in many facets of transplantation biology, including rejection and tolerance, ischemia/reperfusion injury (IRI), and infections after transplantation. The role of TLRs in liver transplantation is unique with respect to other organ transplants because the portal circulation is a continuous source of TLR2 and TLR4 ligands, and this influences TLR signaling pathways, which have a central role in transplantation immunity. This review provides a critical update on recent data outlining the important role of TLRs in liver transplantation, and there is a particular focus on emerging advances in our understanding of rejection and tolerance, IRI, and infections after transplantation and on the ways in which these events may influence the recurrence of diseases such as hepatitis C infection after liver transplantation. Liver Transpl 20:270-280, 2014. © 2013 AASLD.

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