title: Hematopoietic stem cell infusion/transplantation for induction of allograft tolerance.
abstract: OBJECTIVE
  The present review updates the current status of basic, preclinical, and clinical research on donor hematopoietic stem cell infusion for allograft tolerance induction.
  
  
  RESULTS
  Recent basic studies in mice provide evidence of significant involvement of both central deletional and peripheral regulatory mechanisms in induction and maintenance of allograft tolerance effected through a mixed chimerism approach with donor hematopoietic stem cell infusion. The presence of heterologous memory T cells in primates hampers the induction of persistent chimerism. Durable mixed chimerism, however, now has been recently induced in inbred major histocompatibility complex-mismatched swine, resulting in tolerance of vascularized composite tissue allografts. In clinical transplantation, allograft tolerance has been achieved in human leukocyte antigen-mismatched kidney transplantation after the induction of transient mixed chimerism or persistent full donor chimerism.
  
  
  CONCLUSIONS
  Tolerance induction in clinical kidney transplantation has been achieved by donor hematopoietic stem cell infusion. Improving the consistency and safety of tolerance induction and extending successful protocols to other organs, and to organs from deceased donors, are critical next steps to bringing tolerance to a wider range of clinical applications.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Center for Transplantation Sciences, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jose M M
authors.initials: JM
authors.lastname: Granados
authors.forename: Gilles
authors.initials: G
authors.lastname: Benichou
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kawai
mesh_terms: D000818:Animals; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000502:physiology*; D006801:Humans; D016030:Kidney Transplantation; D051379:Mice; D019172:Transplantation Conditioning; D023001:Transplantation Tolerance / Q000276:immunology*; D014184:Transplantation, Homologous