ABSTRACT
Immune tolerance after liver transplantation refers to discontinuing use of immunosuppressants in varying patterns and maintaining the long-term stability of liver function of the recipients. At present, immune tolerance may be achieved by passive immune tolerance, active operational immune tolerance and induced immune tolerance. Multiple clinical trials have confirmed the safety and feasibility of these approaches. Compared with adults, pediatric recipients undergoing liver transplantation have better potential of immune tolerance, especially the living donor liver transplant recipients. Nevertheless, it remains a challenge to predict whether a certain individual may achieve immune tolerance. In this article, research progresses on the characteristics of immune tolerance in pediatric recipients, induction of immune tolerance, operational immune tolerance, induced immune tolerance, screening of recipients and tolerance markers were reviewed, aiming to provide reference for the formulation of postoperative immunosuppressant regimens, reduce the overall exposure to immunosuppressants and lower the risk of adverse reactions induced by immunosuppressants in children undergoing liver transplantation.