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[PDF: Members Only] J.Jpn. Surg. Soc.. 121(2): 202-209, 2020
Feature topic
CLINICAL TRANSPLANTATION TOLERANCE TO DATE
In the past few decades, with developments in immunology and pharmacology, organ transplantation has become widely established as a standard medical procedure to regenerate organ function. However, as a result of this achievement, lifelong immunosuppression has become necessary to prevent immune rejection and injury to allografts which increase the risk of severe infections, de novo cancer, and progression of metabolic disease, as well as healthcare economic problems. This review summarizes the results of clinical trials assessing transplant tolerance. The chimerism approach to induce tolerance has been established, although the precise mechanism of that tolerance is still being investigated. The peripheral tolerance approach based on immunomodulatory cell therapy has recently been introduced and acceptable results have been achieved. However, the diagnostic biomarkers of tolerance are not yet standardized. A new Japanese multicenter clinical trial examining the induction of tolerance is planned for the near future.
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