Managing the highly sensitized transplant recipient and B cell tolerance

Curr Opin Immunol. 2001 Oct;13(5):577-81. doi: 10.1016/s0952-7915(00)00262-4.


The detection of anti-donor-HLA antibodies in a renal allograft recipient's serum, either at the time of or after transplantation, is usually associated with specific antibody-mediated clinical syndromes. These can be divided temporally into three categories: hyperacute rejection, acute humoral rejection and chronic humoral rejection. With the identification of new immunosuppressive drug combinations, more-effective control of alloantibody production has been recently achieved in humans. Thus, prevention and/or treatment of antibody-mediated allograft injury are now possible. Ultimately, the induction of mixed hematopoietic chimerism may allow us to overcome the problem of allosensitization and accept an allograft without chronic immunosuppression.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • B-Lymphocytes / immunology*
  • HLA Antigens / immunology*
  • Humans
  • Immunization / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Isoantibodies / biosynthesis
  • Transplantation Tolerance / immunology*


  • HLA Antigens
  • Immunosuppressive Agents
  • Isoantibodies