Tolerance: is it achievable in pediatric solid organ transplantation?
Significant advances have been made in the understanding of allograft rejection. There is growing awareness that allograft acceptance, or tolerance, is also an active process rather than a passive absence of rejection. Mechanistic awareness of this process has spawned many preclinical strategies for the prevention of allograft rejection without the need for chronic immunosuppression. These therapies are currently entering clinical trials. This article reviews the prevailing therapies that hold promise for future clinical application. In particular, their application in children is discussed, as are biologic aspects of childhood immunity that may play a role in the success or failure of these strategies.
Pearl
Jonathan P
JP
Department of Surgery, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600, USA.
Preston
Edwin
E
Kirk
Allan D
AD
D000818:Animals; D018106:CD28 Antigens / Q000276:immunology; D023201:CD40 Ligand / Q000276:immunology; D002648:Child; D006801:Humans; D007108:Immune Tolerance; D008212:Lymphocyte Depletion; D018183:Transplantation Chimera / Q000276:immunology; D014181:Transplantation Immunology / Q000276:immunology*
D018106:CD28 Antigens; D023201:CD40 Ligand