Sensitization and Survival in Renal Transplantation
1.1.1. T cells, HLA-vigilantes. During foetal development lymphocytes (T cells) learn to recognize self HLA gene products (Jerne 1981). Many react vigorously to foreign HLA antigens carried by other individuals, even without prior contact with these antigens. How this apparent commitment to foreignness develops has no complete explanation, but the most plausible theory, not necessarily correct in detail, is that alloimmunity is a by-product of T cell differentiation. Normally pre-T cells enter thymic cortical tissue, differentiate into cells that bind loosely to self HLA and emerge into the post-thymic pool there to function as HLA-vigilantes, surveying the body for HLA associated unwanted or foreign antigens. This vital role is dramatically illustrated by individuals born with defective expression of HLA; they develop fatal immunodeficiency disease (Touraine et al 1978, Schuurman et al 1979).
KeywordsGraft Survival Graft Failure Graft Rejection Delay Graft Function Kidney Graft
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