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Nephrol Dial Transplant (2003) 18: 1979-1982
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comment

Transplantation tolerance: a journey from ignorance to memory

Fadi G. Lakkis

Section of Nephrology, Department of Internal Medicine and Section of Immunobiology, Yale University School of Medicine, New Haven, CT, USA

Correspondence and offprint requests to: Fadi G. Lakkis, MD, Yale University School of Medicine, Section of Nephrology, 333 Cedar Street, PO Box 208029, New Haven, CT 06520-8029, USA. Email: fadi.lakkis@yale.edu

Keywords: cytokines; memory T lymphocytes; primary immune response; transplantation tolerance

The first 10% of the full text of this article appears below.

Transplantation tolerance can be defined as long-term allograft survival in the absence of continuous immunosuppressive therapy. Implicit to this definition is that tolerant recipients of organ transplants are unresponsive to donor antigens but maintain reactivity to other (third-party) antigens. In other words, a tolerant patient is capable of mounting an effective immune response against microbial pathogens but is incapable of rejecting the transplanted organ.

Despite a wealth of information on how tolerance to self-antigens is maintained (Figure 1), the induction of tolerance to a transplanted organ remains elusive because of several biological barriers. These barriers include the relatively large magnitude of the alloimmune response, the limitations of peripheral tolerance mechanisms, and the unavoidable fact that immune responses to foreign antigens, by virtue of evolutionary design, are destined . . . [Full Text of this Article]

Introduction

Ignorance is bliss

Cytokines: friends or foes?

Undesirable memories

Concluding remarks


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