ReviewFrontiers in immunology2017
Transplantation Tolerance through Hematopoietic Chimerism: Progress and Challenges for Clinical Translation.
Review in Frontiers in immunology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 43 citations in OpenAlex.
- Current status of xenotransplantation from an immunobiological standpoint.Clinical transplantation and research · 2025Review
- Combined Haploidentical Hematopoetic Stem Cell Transplantation and Liver Transplantation in a Pediatric Patient.International journal of hematology-oncology and stem cell research · 2023Article
- Biased IL-2 signals induce Foxp3-rich pulmonary lymphoid structures and facilitate long-term lung allograft acceptance in mice.Nature communications · 2023Article
- Outcomes of adults with lymphoma treated with nonmyeloablative TLI-ATG and radiation boost to high risk or residual disease before allogeneic hematopoietic cell transplant.Bone marrow transplantation · 2022Article
- Precision medicine in transplantation and hemodialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Article
- Distinct roles for major and minor antigen barriers in chimerism-based tolerance under irradiation-free conditions.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- The intragraft vascularized bone marrow component plays a critical role in tolerance induction after reconstructive transplantation.Cellular & molecular immunology · 2021Article
- Expansion of CD45RAClinical & translational immunology · 2021Article
- A Large-Scale Bank of Organ Donor Bone Marrow and Matched Mesenchymal Stem Cells for Promoting Immunomodulation and Transplant Tolerance.Frontiers in immunology · 2021Review
- Review
- Extracellular vesicles as mediators of alloimmunity and their therapeutic potential in liver transplantation.World journal of transplantation · 2020Review
- The importance of MHC class II in allogeneic bone marrow transplantation and chimerism-based solid organ tolerance in a rat model.PloS one · 2020Article
- A Prospective Controlled Trial to Evaluate Safety and Efficacy ofFrontiers in medicine · 2020Article
- Treg Therapies Revisited: Tolerance Beyond Deletion.Frontiers in immunology · 2020Review
- Impact of infection on transplantation tolerance.Immunological reviews · 2019Review
- Post-transplantation cyclophosphamide for chimerism-based tolerance.Bone marrow transplantation · 2019Review
- The past, present, and future of costimulation blockade in organ transplantation.Current opinion in organ transplantation · 2019Review
- Transplantation of donor grafts with defined ratio of conventional and regulatory T cells in HLA-matched recipients.JCI insight · 2019Article
- Allograft and patient survival after sequential HSCT and kidney transplantation from the same donor-A multicenter analysis.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Article
- Induction of Tolerance Towards Solid Organ Allografts Using Hematopoietic Cell Transplantation in Large Animal Models.OBM transplantation · 2019Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The perception that transplantation of hematopoietic stem cells can confer tolerance to any tissue or organ from the same donor is widely accepted but it has not yet become a treatment option in clinical routine. The reasons for this are multifaceted but can generally be classified into safety and efficacy concerns that also became evident from the results of the first clinical pilot trials. In comparison to standard immunosuppressive therapies, the infection risk associated with the cytotoxic pre-conditioning necessary to allow allogeneic bone marrow engraftment and the risk of developing graft-vs.-host disease (GVHD) constitute the most prohibitive hurdles. However, several approaches have recently been developed at the experimental level to reduce or even overcome the necessity for cytoreductive conditioning, such as costimulation blockade, pro-apoptotic drugs, or Treg therapy. But even in the absence of any hazardous pretreatment, the recipients are exposed to the risk of developing GVHD as long as non-tolerant donor T cells are present. Total lymphoid irradiation and enriching the stem cell graft with facilitating cells emerged as potential strategies to reduce this peril. On the other hand, the long-lasting survival of kidney allografts, seen with transient chimerism in some clinical series, questions the need for durable chimerism for robust tolerance. From a safety point of view, loss of chimerism would indeed be favorable as it eliminates the risk of GVHD, but also complicates the assessment of tolerance. Therefore, other biomarkers are warranted to monitor tolerance and to identify those patients who can safely be weaned off immunosuppression. In addition to these safety concerns, the limited efficacy of the current pilot trials with approximately 40-60% patients becoming tolerant remains an important issue that needs to be resolved. Overall, the road ahead to clinical routine may still be rocky but the first successful long-term patients and progress in pre-clinical research provide encouraging evidence that deliberately inducing tolerance through hematopoietic chimerism might eventually make it from dream to reality.
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