c l i n i c a l f o l i o s : d i s c u s s i o n

Kidney Transplant



Related narrative: Kidney Transplant

Transplantation immunology is a rapidly evolving field in which the groundbreaking work of the past 50 years has laid the foundation for exciting new approaches to overcome organ rejection. These new approaches include costimulation blockade, lymphodepletion strategies, and also the future possibility of the use of embryonic stem cells to regrow diseased organs.

Costimulation blockade involves the interruption of cell surface interactions between T-cells and antigen presenting cells in order to produce antigen specific anergy. Initial results in rhesus monkeys with humanized anti-CD154 monoclonal antibodies has been encouraging, and clinical trials in humans have begun using this strategy.

Lymphodepletion efforts, with such agents as anti-CD52 directed against lymphocytes and monocytes, have also shown promise in small human series and clinical trials in humans are also underway. Stem cell research is currently in its infancy but may hold the promise of repopulating diseased organs and tissues with either self or donor derived pluripotent cells, alleviating the need for donor organs.

Another method of addressing the worldwide shortage of organs for transplantation involves the use of xenotransplantation. Although many obstacles to successful xenotransplantation such as delayed xenograft rejection remain, initial success with hyperacute rejection is promising. These, along with many other approaches, will form the basis of future transplantation across all barriers.

This page was last modified on 7-Mar-2000.