Chimerism-based tolerance in organ transplantation: preclinical and clinical studies.
Clin Exp Immunol
; 189(2): 190-196, 2017 08.
Article
em En
| MEDLINE
| ID: mdl-28369830
ABSTRACT
Induction of allograft tolerance has been considered the ultimate goal in organ transplantation. Although numerous protocols to induce allograft tolerance have been reported in mice, a chimerism-based approach through donor haematopoietic stem cell transplantation has been the only approach to date that induced allograft tolerance reproducibly following kidney transplantation in man. Renal allograft tolerance has been achieved by induction of either transient mixed chimerism or persistent full donor chimerism. Although the risk of rejection may be low in tolerance achieved via durable full donor chimerism, the development of graft-versus-host disease (GVHD) has limited the wider clinical application of this approach. In contrast, tolerance induced by transient mixed chimerism has not been associated with GVHD, but the risk of allograft rejection is more difficult to predict after the disappearance of haematopoietic chimerism. Current efforts are directed towards the development of more clinically feasible and reliable approaches to induce more durable mixed chimerism in order to widen the clinical applicability of these treatment regimens.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Quimeras de Transplante
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Transplante de Células-Tronco Hematopoéticas
/
Condicionamento Pré-Transplante
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Tolerância ao Transplante
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Doença Enxerto-Hospedeiro
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Animals
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Humans
Idioma:
En
Revista:
Clin Exp Immunol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos