Immune Tolerance Induction: Basic Concepts for Composite Tissue Allotransplantation

  • Patricio Andrades
  • Clement Asiedu
  • Judith M. Thomas

Despite remarkable progress in contemporary transplantation there are still major unresolved problems in the field. First, although immunosuppressive drugs have dramatically improved the life of transplant recipients over the past 30 years, they are associated with significant toxicities. This includes both the toxicities of immunosuppression itself (enhanced risk of opportunistic infections and selected malignancies), and side effects unrelated to immunosuppression (nephrotoxicity of calcineurin inhibitors, hypertension and cardiovascular disease from corticosteroids, etc.). Second, these agents have proven very successful in the prevention and treatment of acute rejection, but similar success has not been achieved in preventing chronic rejection and extending graft survival for decades. Even though various promising new agents are currently being developed and investigated, the undeniable conclusion is that chronic immunosuppressive drug therapy in its present status is not a satisfactory solution to the unremitting problem of host alloaggressiveness. This is a major obstacle to widespread application of composite tissue transplantation that can potentially be eliminated by induction of transplantation tolerance.


Tolerance Induction Donor Bone Marrow Curr Opin Immunol Transplantation Tolerance Costimulatory Pathway 
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Copyright information

© Springer 2008

Authors and Affiliations

  • Patricio Andrades
    • 1
  • Clement Asiedu
    • 2
  • Judith M. Thomas
    • 3
  1. 1.Division of Plastic and Reconstructive Surgery, Department of Surgery, Jose Jaoquin Aquirre Clinical HospitalUniversity of Chile School of MedicineSantiago
  2. 2.Department of SurgeryUniversity of Alabama at BirminghamBirmingham
  3. 3.Departments of Surgery and MicrobiologyUniversity of Alabama at Birmingham School of MedicineBirmingham

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