Evolving paradigms that determine the fate of an allograft: Minireview

J. S. Bromberg, P. S. Heeger, X. C. Li

Research output: Contribution to journalShort surveypeer-review

15 Scopus citations


Despite the many advances in both immunological knowledge and the practical application of clinical immunosuppression, the holy grail of indefinite graft survival with immune tolerance in clinical solid organ transplantation remains a distant dream. The tremendous progress made in understanding the molecular and cellular basis of allograft rejection has not been translated into durable modalities that have advanced clinical care and outcomes. Indeed, currently used drugs and treatment protocols, largely directed at inhibiting alloreactive T cells, have not optimally improved allograft survival or function. A shift in emphasis, focusing on under appreciated immune pathways must now be considered to make further improvement. We highlight three areas of recent interest, complement, NK cells and lymphatics, which reinforce the concept that the transplant community must direct attention on how the immune system as a whole responds to a transplant. The current challenge is to integrate molecular, cellular and anatomic concepts to achieve the equivalent of a unified field theory of the immune response to organ transplants.

Original languageEnglish (US)
Pages (from-to)1143-1148
Number of pages6
JournalAmerican Journal of Transplantation
Issue number5
StatePublished - May 2010


  • Complement
  • Lymph node
  • Lymphocyte trafficking
  • Natural killer cells
  • Rejection
  • Tolerance

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)


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