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Related Experiment Video

Updated: Mar 12, 2026

In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
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Tolerance in Solid-Organ Transplant.

Richard N Fine1

  • 1Stony Brook Medicine, Stony Brook, New York 11794, USA.

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Summary
This summary is machine-generated.

Achieving operational tolerance in organ transplants remains challenging. New methods using regulatory T cells and hematopoietic cell transplants show promise for weaning immunosuppression and improving long-term graft function.

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Area of Science:

  • Immunology
  • Transplantation Medicine
  • Regenerative Medicine

Background:

  • Immunotolerance, or non-recognition of specific tissue, has been elusive in human solid-organ transplantation since its initial demonstration in animals.
  • Clinical operational tolerance, defined by stable graft function exceeding one year without immunosuppression, has been observed in select kidney and liver transplant recipients.
  • Identifying reliable biomarkers to differentiate tolerant from non-tolerant transplant recipients has proven unsuccessful.

Purpose of the Study:

  • To review current strategies and emerging methodologies for achieving clinical operational tolerance in solid-organ transplant recipients.
  • To explore the potential of novel approaches, including regulatory T cell therapy and combined transplantation, to facilitate immunosuppression weaning.
  • To discuss the future implications of these advancements for long-term graft survival and patient outcomes.

Main Methods:

  • Review of existing literature on immunotolerance and clinical operational tolerance in organ transplantation.
  • Analysis of strategies involving immunosuppression weaning in liver and kidney transplant recipients.
  • Examination of novel therapeutic approaches such as combined kidney and hematopoietic cell transplantation and ex vivo expanded autologous regulatory T cell infusions.

Main Results:

  • While true immunotolerance has not been achieved in human solid-organ transplants, clinical operational tolerance has been observed in some recipients.
  • Successful immunosuppression weaning has been reported in 60% of pediatric and 20% of adult liver transplant recipients.
  • Combined kidney and hematopoietic cell transplantation has induced chimerism and allowed for immunosuppression weaning in kidney transplant recipients.
  • Ex vivo expanded autologous regulatory T cells have facilitated immunosuppression weaning in liver transplant recipients, with ongoing trials for kidney recipients.

Conclusions:

  • Emerging strategies, particularly those involving regulatory T cells and combined transplantation, hold significant potential for inducing clinical operational tolerance.
  • These advancements offer a pathway to eliminate long-term reliance on immunosuppressive medications, thereby mitigating associated adverse effects.
  • The future outlook suggests that clinical operational tolerance may become achievable for a broader range of solid-organ transplant recipients.