Chimerism and thoracic organ transplantation.
Current nonspecific immunosuppression for thoracic organ transplantation is limited by infection, end-organ toxicity, malignancy, and failure to completely control rejection. Donor-specific transplantation tolerance after bone marrow transplantation and the creation of mixed chimerism is a promising means for achieving drug-free allograft acceptance. This review explores bone marrow transplantation as a method for tolerance induction, the superior clinical characteristics of mixed chimerism, and recent developments that enhance marrow engraftment, minimize graft-versus host disease, and avoid lethal conditioning of the recipient. The importance of microchimerism in clinical transplantation and clinical trials aimed at augmentation of this phenomenon are reviewed.
Gammie
J S
JS
Division of Cardiothoracic Surgery, University of Pittsburgh Medical Center, PA 15261, USA.
Colson
Y L
YL
Griffith
B P
BP
Pham
S M
SM
D000818:Animals; D016026:Bone Marrow Transplantation; D002678:Chimera; D006086:Graft vs Host Disease / Q000235:genetics / Q000276:immunology; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D016040:Lung Transplantation / Q000502:physiology*; D013601:T-Lymphocytes / Q000502:physiology; D014181:Transplantation Immunology