Chimerism-Mediated Tolerance in Intestinal Transplantation

Gastroenterol Clin North Am. 2024 Sep;53(3):413-430. doi: 10.1016/j.gtc.2023.12.009. Epub 2024 Jan 16.

Abstract

In this review, the authors outlined concepts and strategies to achieve immune tolerance through inducing hematopoietic chimerism after solid organ transplantation and introduced challenges and opportunities in harnessing two-way alloresponses to improve outcomes after intestinal transplantation (ITx). Next, the authors discussed the dynamics and phenotypes of peripheral blood and intestinal graft T-cell subset chimerism and their association with outcomes. The authors also summarized studies on other types of immune cells after ITx and their potential participation in chimerism-mediated tolerance. The authors further discussed strategies and future directions to promote chimerism-associated tolerance after ITx to overcome rejection and minimize immunosuppression.

Keywords: Bidirectional alloresponses; Chimerism; Intestinal transplantation; LGVHR; Tolerance.

Publication types

  • Review

MeSH terms

  • Chimerism
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control
  • Humans
  • Immune Tolerance
  • Intestines* / immunology
  • Intestines* / transplantation
  • Organ Transplantation / methods
  • Transplantation Chimera* / immunology
  • Transplantation Tolerance / immunology