The (re)emergence of B cells in organ transplantation.
OBJECTIVE
To outline recent advances in our understanding of the role of B cells in transplantation.


RESULTS
While T-cell-mediated alloimmunity has been largely controlled using immunosuppression, the role of B cells in transplantation is just beginning to be understood. Recent studies have outlined some of the important clinical issues involving antibody including early acute humoral rejection and late transplant glomerulopathy. In addition, recent studies have identified bone-marrow-derived long-lived plasma cells that appear to be a major source of donor-specific alloantibody in sensitized renal transplant recipients. New agents are being tested that deplete these cells in vitro and in vivo. Memory B cells appear to be important in early acute humoral rejection, but few basic studies have been performed. Finally, recent studies involving patients undergoing tolerogenic regimens suggest that T-cell tolerance does not always convey tolerance in naive B cells.


CONCLUSIONS
Several B cell types have clear and specific roles in transplant recipients. Although our understanding of B cells in transplantation has improved, important gaps remain.
Stegall
Mark D
MD
Division of Transplantation Surgery, Department of Surgery, von Liebig Transplant Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. stegall.mark@mayo.edu
Raghavaiah
Suresh
S
Gloor
James M
JM
D000818:Animals; D001402:B-Lymphocytes / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology* / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D056724:Immunity, Humoral; D007156:Immunologic Memory; D007518:Isoantibodies / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D016896:Treatment Outcome
D007518:Isoantibodies