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Publications

Journal Article Review Research Support, Non-U.S. Gov't Epublish

PubMed: 40387984 DOI: 10.1007/s00281-025-01052-x

Chimerism and immunological tolerance in solid organ transplantation.

Semin Immunopathol 47(1):27

Authors: Birte Ohm, Anastasios D Giannou, David Harriman, Jun Oh, Wolfgang Jungraithmayr, Dimitra E Zazara

Affiliations

  • Department of Thoracic Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.
  • Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
  • Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
  • Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • General Surgery, Liver, Pancreas and Intestinal Transplant Unit, Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina.
  • Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.
  • University Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
  • Division of Thoracic Surgery, Rostock University Medical Center, Rostock, Germany.
  • Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
  • University Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
  • Division for Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.

Abstract

In solid organ transplantation, chimerism inevitably occurs via the coexistence of donor-derived cells from the graft and host cells throughout the recipient. However, long-term immunosuppressive treatment is needed to suppress host immune responses to the foreign organ graft. The deliberate induction of stable mixed bone marrow chimerism to achieve donor-specific immunological tolerance in solid organ graft recipients is an ambitious goal that may significantly contribute to the long-term survival of solid organ grafts and their recipients. While this strategy has been effectively established in laboratory animals and some promising clinical case series have been reported, widespread clinical application is still limited by the toxicity of the necessary conditioning regimens. On the other hand, the naturally occurring chimeric state resulting from the bidirectional transplacental cell trafficking during pregnancy, the so-called feto-maternal microchimerism, can also induce immune tolerance and thus influence the outcome of mother-to-child or child-to-mother organ transplantation. This review provides an overview of the field's historical development, clinical results, and underlying principles of (micro) chimerism-based tolerance.

MeSH

Cells, Mothers, Chimerism, Transplants, Allergy And Immunology, Organ Transplantation, Transplantation, Child

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