Abstract
Problem statement: Organ transplantation is a life-saving and increasi ngly common procedure, as it often serves as the only treatment available for end-stage organ disease. Although th e constant development of new and more effective immunosuppressive drugs has revolutionized the prevention and treatment of acute graft rejection, these drugs have significant toxicity, greatly incr ease patient susceptibility to neoplasms and infection a nd exert little impact on chronic rejection. Approach: The literature was reviewed to illuminate the mech anisms by which the anti-donor immune response is initiated and how cellular therapies im pact this response. Results: Data show that Donor Specific Transfusion, Apoptotic Cell therapies and Dendritic Cell therapies all function as a source o f alloantigen to suppress the anti-donor T cell respo nse. Conclusion: Cellular therapies hold promise in the prevention of solid organ allograft rejection, but require optimization and study in large animal mode ls before clinical implementation.
Highlights
Organ transplantation is becoming an increasingly important and common surgical procedure, as transplantation surgery often serves as the only life-saving treatment available for end-stage organ disease
Recent data though have shown that Dendritic Cells (DC)-based therapy, like Donor Specific Transfusion (DST) and apoptotic cell-based therapies all function via a similar mechanism, that is as a source of alloantigen for presentation by recipient Ag-Presenting Cells (APC) to T cells
Dendritic cell-based therapies in transplantation of solid organ allografts: DC are a heterogeneous population of hematopoietic-derived APC that orchestrate the adaptive immune response to self- and foreign-Ag
Summary
Organ transplantation is becoming an increasingly important and common surgical procedure, as transplantation surgery often serves as the only life-saving treatment available for end-stage organ disease. Acute rejection begins within weeks or months (5 days to 3 months is typical), or in rare cases even years, following transplantation and constitutes the main immediate threat to allograft survival It is mediated by both innate and adaptive immune responses, the advent of immunosuppressive drugs renders acute rejection largely preventable. Calcineurin phagocytes and activated by products of necrotic cells inhibitors such as tacrolimus and cyclosporine that or extracellular matrix disruption These agents non- suppress the immune system, greatly increasing patient susceptibility to opportunistic infections and various cancers. Complexes (Lombardi et al, 1989)
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