Principles of transplantation immunology

Since the first successful transplant of a kidney between identical twins in 1954, transplantation has progressed from being an experimental procedure to a routine clinical therapy offering immense benefits for patients with organ failure. However, the survival of transplanted organs remains limited by the body’s immune responses, and many of the complications of transplantation result from the crude nature of our attempts to suppress these. This chapter explains how the survival of transplanted organs remains limited by the body’s immune responses, which are designed to discriminate between ‘self’ and ‘non-self’ or ‘altered-self’, and how many of the complications of transplantation result from the crude nature of our attempts to suppress these.