title: Chimerism and thoracic organ transplantation.
abstract: 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.
authors.affiliation: Division of Cardiothoracic Surgery, University of Pittsburgh Medical Center, PA 15261, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Gammie
authors.forename: Y L
authors.initials: YL
authors.lastname: Colson
authors.forename: B P
authors.initials: BP
authors.lastname: Griffith
authors.forename: S M
authors.initials: SM
authors.lastname: Pham
mesh_terms: 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