Clinical Tolerance in Kidney Transplantation

Abstract

Induction of donor specific tolerance has been the ultimate goal in organ transplantation. Recent application of approaches to the induction of allograft tolerance in human kidney transplant recipients has been based upon preclinical studies in nonhuman primates, including 1) profound T cell depletion by powerful anti-T cell antibodies, 2) use of total lymphoid irradiation, 3) costimulatory blockade, 4) infusion of anergic cells 5) donor bone marrow (DBM) infusion without anticipation of engraftment and 6) DBM transplantation leading to Mixed Chimerism. Mixed Chimerism following DBM transplantation has to date been the most successful approach for induction of renal allograft tolerance in clinical kidney transplantation trials.

Keywords: Tolerance, Mixed Chimerism, Kidney Transplantation, Immunosuppression, Central Tolerance, Peripheral Tolerance, Prope Tolerance, Costimulatory Blockade, T-Cells Depletion, Blood Marrow Infusion.