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Letter to the Editor: Induction immunotherapy in hyperimmunized liver transplantation: Rebalancing immunological risk and graft protection
Jin-Wei Zhang, State Key Laboratory of Chemical Biology, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, China
Jin-Wei Zhang, Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter EX4 4PS, Devon, United Kingdom
Author contributions: Zhang JW designed the overall concept and outline of the manuscript, contributed to the discussion and design of the manuscript, contributed to the writing and editing of the manuscript, illustrations, and review of the literature.
Supported by National Natural Science Foundation of China, No. 82170406 and No. 81970238.
Conflict-of-interest statement: The author reported no relevant conflicts of interest for this article.
Corresponding author: Jin-Wei Zhang, PhD, Principal Investigator, Professor, State Key Laboratory of Chemical Biology, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, No. 345 Lingling Road, Shanghai 200032, China. jinweizhang@sioc.ac.cn
Received: January 12, 2026
Revised: March 27, 2026
Accepted: May 8, 2026
Published online: August 27, 2026
Processing time: 221 Days and 18.6 Hours
Revised: March 27, 2026
Accepted: May 8, 2026
Published online: August 27, 2026
Processing time: 221 Days and 18.6 Hours
Core Tip
Core Tip: For decades, hyperimmunized liver transplant recipients have faced poorer clinical outcomes due to their heightened immunological risk profile, leaving clinicians with limited evidence-based management options. This editorial delivers a comprehensive analysis of EL-Domiaty et al’s landmark study, which provides compelling clinical evidence that a short-course induction regimen of rabbit anti-T-lymphocyte globulin plus intravenous immunoglobulin can effectively mitigate early rejection risk and align outcomes with those of non-immunized recipients. This work highlights a viable, pragmatic strategy for managing this challenging patient population and paves the way for more personalized immunosuppression in liver transplantation.