Clinical parameters and biomarkers predicting spontaneous operational tolerance after liver transplantation: a scoping review protocol

Autor: Christian Appenzeller-Herzog, Julien Vionnet, Steffen Hartleif
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
medicine.medical_specialty
medicine.medical_treatment
MEDLINE
Tregs
Disease
Cochrane Library
Liver transplantation
030230 surgery
General Biochemistry
Genetics and Molecular Biology
03 medical and health sciences
Study Protocol
0302 clinical medicine
gene expression profiling
Medicine
Humans
Biomarkers
Child
Immunosuppression/methods
Liver Transplantation
Research Design
Review Literature as Topic
Transplantation Tolerance
biomarker
clinical parameter
flow cytometry
immunosuppression
immunosuppression withdrawal
liver biopsy
liver transplantation
operational tolerance
regulatory lymphocytes
scoping review
General Pharmacology
Toxicology and Pharmaceutics
Intensive care medicine
Hepatitis
Immunosuppression Therapy
General Immunology and Microbiology
business.industry
General Medicine
Articles
medicine.disease
3. Good health
Clinical trial
Data extraction
Biomarker (medicine)
030211 gastroenterology & hepatology
business
Zdroj: F1000Research
F1000Research, vol. 8, pp. 2059
Popis: Objective: This scoping review aims at systematically mapping reported prognostic factors for spontaneous immunosuppression (IS) free allograft tolerance (operational tolerance, OT) in non-viral hepatitis and non-autoimmune disease liver transplant (LT) recipients who are undergoing immunosuppression withdrawal (ISW). The results may inform the subsequent conduct of a systematic review with a more specific review question. Background: LT is currently the most effective treatment for end-stage liver diseases. Whereas the short-term outcomes after LT have dramatically improved over the last decades, the long-term outcomes remain unsatisfactory, mainly because of side effects of lifelong IS, such as infections, cardiovascular diseases, malignancies, and nephrotoxicity. ISW studies have shown that OT can be achieved by a subset of LT recipients and recent research has identified biomarkers of OT in these patients. However, an evidence-based selection algorithm for patients that can predictably benefit from ISW is not available to date. The planned review will, therefore, map existing knowledge on prognostic clinical parameters and biomarkers for OT. Inclusion criteria: We will consider studies that record any clinical parameter or biomarker before the initiation of ISW in paediatric or adult non-viral hepatitis and non-autoimmune disease LT recipients and analyse their possible association with ISW outcomes (OT or non-tolerance). Studies addressing the effectiveness of OT-inducing treatments will be excluded. Methods: Embase, MEDLINE, and Cochrane Library will be searched for relevant articles or conference abstracts. Full-texts of selected abstracts will be independently screened for inclusion by two reviewers. References and citing articles of included records will be screened for additional relevant records. Clinical trial registries will be searched for ongoing studies, and their investigators contacted for the sharing of unpublished data. Data from included records will be independently extracted by two reviewers using a prespecified data extraction table and presented in both tabular and narrative form.
Databáze: OpenAIRE
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