From ABO-incompatible human kidney transplantation to xenotransplantation

The development (in 1981) of a protocol for successful renal allotransplantation across ABO barriers is outlined. From this experience, the concept of "adaptation", subsequently termed "accommodation", was defined. It was then hypothesized that a similar approach might allow pig-to-human organ xenotransplantation. This hypothesis was explored in the pig-to-baboon renal transplantation model, with graft survival for a maximum of 23 days. Rejection episodes were temporarily reversed, providing encouragement that discordant xenotransplantation would one day prove successful. Finally, the preparation of the thymokidney, developed as a means of inducing xenotolerance, is briefly reviewed.