Tolerogenic protocols for intestinal transplantation

Transplant Immunology
Jacques Pirenne, Masaru Kawai

Abstract

The intestine has long been considered as a "forbidden" organ to transplant [Ann. Surg. 216 (1992) 223-33]. This is due to the particularly challenging nature of the immunological conflict that an intestinal graft may cause: a particularly vigorous rejection response, in addition to the capacity to mount a graft-versus-host disease (GVHD) [Transplantation 37 (1984) 429]. Currently, the short-term success of intestinal transplantation (Itx) depends upon the chronic delivery of profound immunosuppression but this causes infection, malignancies--in particular posttransplant lymphoproliferative disorder (PTLD)--and direct drug toxicity. For these reasons, the results of Itx remain inferior to those of other solid organ transplants in the middle and in the long term (Intestinal Transplant Registry: www.small-bowel-transplant.org). Improved results and wider application of Itx requires the development of protocols that would facilitate acceptance of the new intestine thereby allowing to reduce the need for immunosuppression with its attending complications. Relevant experimental data and the recent evolution in the clinical strategies used to promote acceptance of intestinal grafts are reviewed.

References

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Citations

Mar 19, 2009·ILAR Journal·Zejing WangRainer Storb
Jan 21, 2014·Journal of Pediatric Surgery·Jorge D Reyes
Jun 3, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Laurens J CeulemansJacques Pirenne
Dec 6, 2011·The Journal of Surgical Research·Thierry YandzaJean Gugenheim
Feb 23, 2010·Transplantation Proceedings·D DierickxJ Pirenne
Aug 21, 2009·Gastroentérologie Clinique Et Biologique·B MessingF Joly
Mar 18, 2008·Pediatric Transplantation·Sharon M BartoshStuart C Sweet
Oct 29, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Kareem M Abu-ElmagdGeorge Mazariegos
Jan 23, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Georgia KostopanagiotouAndreas G Tzakis
Sep 6, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·K M Abu-ElmagdA Zeevi
Jun 5, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L J CeulemansJ Pirenne
Dec 18, 2013·International Reviews of Immunology·Dominik MeierGabriel E Gondolesi
Apr 18, 2009·Current Opinion in Organ Transplantation·Jacques Pirenne, Masaru Kawai

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