Can spleen transplantation induce tolerance? A review of the literature.
In some rodent strain combinations, allogeneic spleen transplantation induces tolerance spontaneously to itself and to other donor-specific organs. In other combinations, a state of tolerance has been achieved in the weakened immune system of the recipient. The data indicate that if a balance can be achieved between host-versus-graft and graft-versus-host responses, tolerance develops, possibly due to the development of suppressor/regulatory cells. There have been a number of unsuccessful studies in outbred large animals, but none in MHC-defined donor-recipient pairs, and none in which the protocol specifically aimed at inducing tolerance. Spleen transplantation has been performed in approximately 50 humans for a number of reasons, however no clear immunologic advantage has been reported. Graft-versus-host disease (GVHD) was documented in at least 3 patients, and was lethal in one case, despite excision of the donor spleen. The advantages of tolerance over chronic immunosuppressive therapy are so great that a potentially tolerogenic approach such as spleen transplantation would seem worthy of further investigation in a suitable large animal model. Such a study is ongoing at our center.
Dor
Frank J M F
FJ
Transplantation Biology Research Center, Massachusetts General Hospital, Havard Medical School, MGH-East, Building 149-9019 13th Street, Boston, Massachusetts,MA 02129, USA.
Gollackner
Bernd
B
Cooper
David K C
DK
D000818:Animals; D006801:Humans; D013154:Spleen / Q000637:transplantation*; D019172:Transplantation Conditioning; D023001:Transplantation Tolerance; D014183:Transplantation, Heterologous; D014184:Transplantation, Homologous