Phase I/II, single center, prospective, open-label, non-controlled, non-randomized, interventional, cohort study in which low risk living donor liver transplant (LDLT) recipients who are between 1 and 3 years after transplantation and meet specific criteria (no positive crossmatch, no clinically treated rejection within 2 years preceding enrollment, permissive liver function tests (LFTs) within 30 days preceding enrollment, no prior liver biopsy showing significant fibrosis or ductopenia\*) will be enrolled and will undergo a protocol liver biopsy unless they have had a permissive liver biopsy\*\* within 90 days of anticipated immunosuppression weaning. Those patients with permissive liver biopsy\*\* will then receive a single infusion of donor-derived DCreg and will remain on their current standard of care (SOC) immunosuppression. One week after DCreg infusion, immunosuppression weaning will be initiated. Recipients will be slowly weaned off immunosuppression. Successfully weaned participants who remain rejection-free will undergo 3 years of follow-up after the last dose of immunosuppression. They will undergo a liver biopsy at 1 yr and 3 yrs after immunosuppression withdrawal. Participants who are removed from the study protocol at any time will return to standard of care but will continue to be followed by the study team and will undergo a liver biopsy at the end of the study. \* Permissive LFTs are defined as ALT, AST and total bilirubin \< 2.5 times the upper limit of normal. \*\*A permissive biopsy is based on 2016 Comprehensive Update of the Banff Working Group on Liver Allograft Pathology (the criteria detailed in Table 8, Demetris et al. 2016).
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The proportion of recipients who experience CTCAE Grade 4 or higher infusion reaction
Timeframe: 1 day
The proportion of recipients who experience CTCAE Grade 4 or higher infection
Timeframe: 4 years
The proportion of recipients who experience experience malignancy other than non-melanoma skin cancer or HCC recurrence
Timeframe: 4 years
The proportion of recipients who experience rejection resulting in recipient death or retransplantation
Timeframe: 4 years
The proportion of recipients who experience biopsy-proven severe acute rejection
Timeframe: 4 years
The proportion of recipients who experience any grade chronic rejection
Timeframe: 4 years
The proportion of recipients who experience non-surgical graft loss
Timeframe: 4 years
The proportion of recipients who die
Timeframe: 4 years
Preliminary Efficacy of using DCreg therapy to facilitate immunosuppression weaning
Timeframe: 2 years