Accommodation in organ transplantation

PURPOSE OF REVIEW: We review recent insights into the mechanisms and prevalence of accommodation. Accommodation refers to an acquired resistance of an organ graft to humoral injury and rejection. RECENT FINDINGS: Accommodation has been postulated to reflect changes in antibodies, control of complement and/or acquired resistance to injury by antibodies, complement or other factors. We discuss the importance of these mechanisms, highlighting new conclusions. SUMMARY: Accommodation may be a common, perhaps the most common, outcome of organ transplantation and, in some systems, a predictable outcome of organ xenotransplantation. Further understanding of how accommodation is induced and by what mechanisms it is manifest and maintained could have a profound impact on transplantation in general and perhaps on other fields.