The immunology of organ transplantation

Transplantation is the best treatment modality for most patients with end-stage organ failure. In addition to the medical and surgical challenges in organ transplantation, the major biological barrier is immunological. These barriers may lead to graft rejection and loss. An understanding of transplant immunology is essential in caring for patients with organ transplants who are on immunosuppression.The aims of this article are to describe commonly used immunological terminology, the immunology of graft rejection (including the mechanisms by which grafts are recognized as foreign by the host immune system), the different types of rejection and how this process may be prevented with immunosuppressive therapy, the practical translation of transplant and, finally, antibody incompatible transplantation. This article aims to afford the reader an overall view of basic transplant immunology that will be of use in clinical setting or in preparation for examinations.