[New trends in immunosuppressive therapy in patients with kidney transplants].
Following the transplantation of visceral organs, two populations of immunocytes survive which derived from the donor's and the recipient's bone marrow. The rejection process of transplanted organ or graft versus host reaction could result from their mutual stimulation. On the other hand, the immunocytes of the donor and recipient could deny the effects of their MHC antigen disparities directed against each other, to favor the transplant acceptance through the processes of the donor specific tolerance. The spontaneous chimerism has been shown even in patients with the heart or kidney allografts which contain few numbers of donor's passenger lymphocytes. The frequency of chimerism is augmenting more than 1000 times following the combined and simultaneous transplantation of both kidney allograft and donor bone marrow cells. Theoretically, the continuous peroraly giving of high doses of synthetic peptides homologous to immunodominate epitope(s) of the donor MHC molecules could sustain the state of "stable chimerism" with donor immunocytes. This immunosuppressive protocol permits long-term survival of organ (kidney) allograft without diminishing the donor immune system that provokes the present immunosuppressives with non-specific effects.
Savić
M
M
Institute of Urology and Nephrology, Clinical Centre of Serbia, Belgrade.
Petrović
V
V
D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D016030:Kidney Transplantation / Q000276:immunology*; D018183:Transplantation Chimera