Primary Graft Dysfunction
This chapter provides an overview of the innate and adaptive immune process as it relates to solid organ transplantation and discusses immune and molecular parameters informative of a patient's status. Innate as well as adaptive immunity contributes to the anti-allograft repertoire. The innate immune system, which comprises monocyte/macrophages, neutrophils, and other granulocytes, is triggered via pattern recognition receptors (PRRs) expressed on their cell surface. The antigen specific immune response is initiated when the host immune cells encounter alloantigens within the allograft and/or the host lymphoid organs. Antigen experienced cells are recruited to the site of inflammation by the chemoattractants. Immune parameters that predict allograft outcome and those that identify individuals requiring modulation of their immune system are beginning to be resolved. Single nucleotide polymorphisms (SNPs), dinucleotide repeats, and microsatellites in genes encoding cytokines, cytokine receptors, chemokines, and their receptors, and adhesion molecules are identified as genomic factors that may influence immune responsiveness of the graft recipient. © 2005 Elsevier Ltd. All rights reserved.
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