Accommodation in renal transplantation: Unanswered questions

Raymond J. Lynch, Jeffrey L. Platt

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations

Abstract

Purpose of Review: Accommodation, an acquired resistance of an organ to immune-mediated damage, has been recognized as an outcome of renal transplantation for more than 20 years. Accommodation was originally identified in blood group-incompatible kidney transplants that survived and functioned normally in recipients with high titers of antiblood group antibodies directed against antigens in the grafts. The most compelling questions today include how often and by which mechanisms accommodation occurs, and what might be the biological implications of accommodation. This communication summarizes recent advances in addressing these questions. Recent Findings: Because its diagnosis has depended on identification of antidonor antibodies in serum, the prevalence of accommodation has been considered low. Recent research in animal models and clinical subjects may challenge that view. This research also suggests that sublethal graft injury of various types induces accommodation and that accommodation may be a dynamic condition, eventuating into tolerance on the one hand and chronic graft injury on the other. Summary: Burgeoning lines of investigation into accommodation now portray a condition of greater prevalence than once thought, exposing pathways that may contribute to the understanding of a range of responses to transplantation.

Original languageEnglish (US)
Pages (from-to)481-485
Number of pages5
JournalCurrent Opinion in Organ Transplantation
Volume15
Issue number4
DOIs
StatePublished - Aug 2010

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Transplantation

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