title: Path to clinical transplantation tolerance and prevention of graft-versus-host disease.
abstract: Although organ and bone marrow transplantations are life-saving procedures for patients with terminal diseases, the requirement for the lifelong use of immunosuppressive drugs to prevent organ graft rejection and the development of graft versus host disease (GVHD) remain important problems. Experimental approaches to solve these problems, first in preclinical models and then in clinical studies, developed at Stanford during the past 40 years are summarized in this article. The approaches use fractionated radiation of the lymphoid tissues, a procedure initially developed to treat Hodgkin's disease, to alter the immune system such that tolerance to organ transplants can be achieved and GVHD can be prevented after the establishment of chimerism. In both instances, the desired goal was achieved when the balance of immune cells was changed to favor regulatory innate and adaptive immune cells that suppress the conventional immune cells that ordinarily promote inflammation and tissue injury.
authors.affiliation: Division of Immunology and Rheumatology, Stanford University School of Medicine, CCSR Building, Room 2215-C, 269 Campus Drive, Stanford, CA, 94305-5166, USA, sstrober@stanford.edu.
authors.forename: Samuel
authors.initials: S
authors.lastname: Strober
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D016377:Organ Transplantation / Q000009:adverse effects; D012106:Research / Q000266:history / Q000639:trends; D014181:Transplantation Immunology; D023001:Transplantation Tolerance