Tremendous developments in surgical procedures, application of anesthetics, and technical understanding of the preservation of organs in transplantation have occurred during the last two to three decades, bringing about a silent revolution in organ transplantation. Indeed, there are several diseases for which transplantation has become the only choice to save the life of a patient. From a surgical point of view, the transplantation operation is usually successful; however, the life-long management of transplantation patients is very difficult. The acute and chronic rejection of the transplanted organs are major problems following transplantation. In most cases, the patients are given immunosuppressive drugs for the rest of their lives, which greatly compromises the quality of life. Two approaches might solve these problems. The first would be to generate artificial organs and to optimize their clinical use. This would definitely revolutionize organ transplantation, but it is unlikely to be realized in the near future. The second approach would be to develop insights into the causes underlying the rejection of allografts and to develop remedies to prevent that rejection. Donor organs that are transplanted into an allogenic recipient contain several types of cells, including parenchymal cells, nonparenchymal cells (endothelial cells, fibroblasts, vascular cells, and specialized cells of the specific transplanted organ), and various types of cells of the immune system. All types of cells from the donor may play a role in the rejection of transplanted organs because all of them have allogenic major histocompatibility complex (MHC) antigens.
KeywordsMajor Histocompatibility Complex Chronic Rejection Liver Allograft Mixed Chimerism Major Histocompatibility Complex Peptide
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