Classic and Current Opinions in Human Organ and Tissue Transplantation

Abstract

Graft tolerance is a pathophysiological condition heavily reliant on the dynamic interaction of the innate and adaptive immune systems. Genetic polymorphism determines immune responses to tissue/organ transplantation, and intricate humoral and cell-mediated mechanisms control these responses. In transplantation, the clinician's goal is to achieve a delicate equilibrium between the allogeneic immune response, undesired effects of the immunosuppressive drugs, and the existing morbidities that are potentially life-threatening. Transplant immunopathology involves sensitization, effector, and apoptosis phases which recruit and engages immunological cells like natural killer cells, lymphocytes, neutrophils, and monocytes. Similarly, these cells are involved in the transfer of normal or genetically engineered T cells. Advances in tissue transplantation would involve a profound knowledge of the molecular mechanisms that underpin the respective immunopathology involved and the design of precision medicines that are safe and effective.

Alternative Therapies in Transplantology as a Promising Perspective in Medicine

“…In addition, although the application of immunosuppressive drugs has contributed to improving short-term survival and graft function, the long-term effects are still unsatisfactory [1]. Based on the genetic variations between the recipient's and donor's tissues, the most common transplantation types are being distinguished: xenograft, allograft, isograft, and autograft [2]. Currently, alternative approaches are supported by novel technologies (eg, based on stem cells or nanotechnology), genetic engineering (an option to use genetically modified and adopted animal organs) [3], and robotics, which provides automatic and minimally invasive cardiac surgery that is safe and feasible although not standardized yet [4].…”