New concepts in HLA and organ transplantation

Authors

  • Jaume Martorell Servei d’Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)
  • Eduard Palou Servei d’Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)

Keywords:

transplantation, HLA, allorecognition, rejection.

Abstract

In organ transplantation, immune rejection is still the biggest obstacle to overcome. The allorecognition that initiates the immune response is determined to a high degree by the recognition as foreign of HLA or MHC (major histocompatibility complex) molecules, the latter being highly polymorphic. The immune alloresponse entails initial T-cell activation and subsequent induction of a variety of effector mechanisms. These mechanisms, which lead to rejection, may have either a cellular or a humoral basis, where immunosuppressive treatment is more effective in the case of cellular rejection. However, chronic treatment with immunosuppressive drugs entails major adverse effects and, therefore, the possibility of inducing antigen-specific tolerance is under study and appears to be a feasible goal in the future. Currently, the immunological studies which are being carried out in the laboratory evaluate the degree of compatibility between donor and recipient through HLA typing of both, and analyse the specific alloresponse, in essence by detecting the presence of donor-specific anti-HLA antibodies.

Key words: transplantation, HLA, allorecognition, rejection.

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