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Immune Tolerance

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Transplantation Surgery

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

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Abstract

Transplantation has become the treatment of choice for patients suffering from end-stage organ failure. However, successful engraftment is currently dependent on the use of non-specific immunosuppressant agents. As a consequence of this treatment, both beneficial and harmful immune responses produced by the recipient are suppressed. Furthermore, in order to permit long-term graft survival, such drugs must be taken indefinitely after transplantation. Such therapy is associated with immunological complications which include the increased risks of infection and malignancy, as well as numerous non-immunological side effects [1]. Another limitation of the current approach to post-transplant immunotherapy is the all too frequent development of chronic rejection. As an example, 50% of all cadaveric renal allografts surviving at one year are lost within only 12–13 years from this largely untreatable condition. Recent advances in immunotherapy have not resulted in an improvement in such half-life statistics over the last 20 years. The problems of increasing demand for transplantation and increasing numbers of patients returning to the transplant pool with failed grafts are clearly interrelated. Approximately 20% of kidney transplants currently performed go to patients who have failed one or more renal allografts. Taken together, these limitations have provided the rationale for continued basic immunological research into tolerance induction.

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Authors
  1. John P. Vella
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  2. Thomas H. W. Stadlbauer
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  3. Meike Schaub
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  4. Mohamed H. Sayegh
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Editors and Affiliations

  1. St Mary’s Hospital, Praed Street, W2 1NY, London, UK

    Nadey S. Hakim MD, PhD, FRCS, FRCSI, FACS, FICS (Consultant General and Transplant Surgeon, Surgical Director Transplant Unit) (Consultant General and Transplant Surgeon, Surgical Director Transplant Unit)

  2. Kidney & Pancreas Transplant Programs, BH-427 Center for the Health Sciences, UCLA School of Medicine, Box 951796, 90095-1796, Los Angeles, CA, USA

    Gabriel M. Danovitch MD (Professor of Medicine) (Professor of Medicine)

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© 2001 Springer-Verlag London

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Vella, J.P., Stadlbauer, T.H.W., Schaub, M., Sayegh, M.H. (2001). Immune Tolerance. In: Hakim, N.S., Danovitch, G.M. (eds) Transplantation Surgery. Springer Specialist Surgery Series. Springer, London. https://doi.org/10.1007/978-1-4471-3689-7_5

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  • DOI: https://doi.org/10.1007/978-1-4471-3689-7_5

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