Prope tolerance--the future of organ transplantation from the laboratory to the clinic

Transplant Immunology
R Calne

Abstract

This is a short review of tolerance from the point of view of the clinician. Various examples of tolerance occurring in patients and animal models that relate to the clinical experience are described. It is suggested that there may be different mechanisms by which tolerance is achieved, but from the patient's point of view operational tolerance is the goal whereby, after a short induction procedure, the patient will maintain good function in the grafted organ indefinitely without maintenance immunosuppression. It is pointed out that such a goal may be difficult to achieve with any given protocol due to the enormous variation between donors and recipients of organ grafts of tissue matching, innate immune reactivity and susceptibility to disturbance of a tolerant state by infections or allergic reactions. Thus, the case is made for prope or almost tolerance in which graft acceptance is maintained by a low, non-toxic dosage of maintenance immunosuppression, which may not be required indefinitely.

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Citations

Oct 11, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B D ReamsS M Palmer
Sep 24, 2004·Transplant Immunology·Thomas Fehr, Megan Sykes
Jul 7, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Kenneth J Woodside, Scott D Lick
Feb 20, 2007·Transplant Immunology·Grégoire WieërsRaymond Reding
Jun 25, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·James A HutchinsonFred Fändrich
Nov 5, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Anthony J DemetrisAngus W Thomson
Jul 20, 2007·Journal of the American Society of Nephrology : JASN·Raffaele Girlanda, Allan D Kirk
Feb 25, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Raymond RedingDominique Latinne
Oct 21, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·David J PostDavid C Mulligan
May 2, 2013·Cambridge Quarterly of Healthcare Ethics : CQ : the International Journal of Healthcare Ethics Committees·Ofra Greenberg
Dec 15, 2015·Neuro-oncology·Annette M MolinaroJeanette E Eckel-Passow
Apr 21, 2016·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jean-Bernard Otte

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