Weber M, Deng S, Olthoff K, Naji A, Barker C F, Shaked A, Brayman K L
Department of Surgery, University of Pennsylvania School of Medicine, USA.
Urol Clin North Am. 1998 Feb;25(1):51-61. doi: 10.1016/s0094-0143(05)70432-8.
Major advances in the understanding of the immunologic process responsible for organ or cellular transplant rejection, a dramatic improvement in available immunosuppressive drugs, development of more sophisticated surgical techniques, and important progress in posttransplant intensive care over the last 30 years have led to a remarkable improvement in success following organ transplantation. Whereas excellent short-term survival of most transplanted organs is readily achieved, graft loss because of chronic rejection and the worsening problem of organ donor shortage remain major concerns in the field of transplantation. Recent advances in immunosuppressive drugs, induction of immunologic tolerance, and gene therapy strategies may help to prolong organ allograft survival in the future. Revised criteria for organ donation and xenotransplantation may one day solve the problem of organ supply. Today, as we approach the next millennium, we are optimistic that the elusive goal of immunologic tolerance will be achieved and perhaps applied to animal tissue. Such will certainly be the challenge for the next century.
在过去30年里，人们对负责器官或细胞移植排斥的免疫过程的理解取得了重大进展，可用的免疫抑制药物有了显著改进，更先进的外科技术得到发展，移植后重症监护也取得了重要进展，这些都使得器官移植后的成功率有了显著提高。虽然大多数移植器官很容易实现优异的短期存活，但由于慢性排斥导致的移植物丢失以及器官供体短缺这一日益严重的问题，仍然是移植领域的主要关注点。免疫抑制药物、免疫耐受诱导和基因治疗策略方面的最新进展，可能有助于在未来延长器官同种异体移植的存活时间。修订后的器官捐赠和异种移植标准或许有一天能解决器官供应问题。如今，在我们迈向新千年之际，我们乐观地认为，免疫耐受这一难以实现的目标将会达成，或许还能应用于动物组织。这无疑将是下个世纪面临的挑战。
