Clinical and basic scientific implications of cell migration and microchimerism after organ transplantation.
Clinical and basic scientific implications of cell migration and microchimerism after organ transplantation.
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器官移植后细胞迁移和微嵌合的临床和基础科学意义。
DOI：
10.1111/j.1525-1594.1997.tb00465.x
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发表时间：
1997
影响因子：
2.4
通讯作者：
Starzl,TE
中科院分区：
文献类型：
--
作者：
Starzl,TE
整个器官移植实践使这种形式的外科治疗达到了高水平的效率和成功，与大多数免疫学家最初的悲观预测相反。从历史上看，同种异体移植物被认为是无防御能力的，容易受到免疫攻击，这与其与受体的组织相容性差异成比例。这一教条将移植定义为骨髓和器官的单向免疫反应（单向范式）（图1）。单向范式在30多年来一直没有受到挑战，直到1992年，我们发现在移植后30年，我们的人类器官受体中普遍存在低水平供体白细胞嵌合体（1，2）。我们根据这些发现（随后获得了许多确证性证据[3-5]）推测，2种共存的供体和受体白细胞群相互作用是骨髓移植后成功耐受以及接受器官同种异体移植的一般机制（图2）。
Whole organ transplantation practices have brought this form of surgical treatment to a high level of efficiency and success, contrary to the pessimistic predictions at the outset of most immunologists. Historically, an allograft was envisioned as defenseless and vulnerable to immunologic attack in proportion to its histocompatibility disparity with that of the recipient. This dogma defined transplantation in terms of a unidirectional immune reaction both for bone marrow and organs (a one-way paradigm)(Fig. 1).The one-way paradigm was unchallenged for more than 3 decades until in 1992, we discovered the presence of ubiquitous low level donor leukocyte chimerism in our human organ recipients as long as 30 years posttransplantation (1, 2). We postulated from these findings (and subsequently obtained much confirmatory evidence [3–5]) that the interaction of 2 coexisting donor and recipient leukocyte populations, each to the other, was the generic mechanism of successful tolerance after bone marrow transplantation as well as the acceptance of organ allografts (Fig. 2).