Transplantation tolerance articles from across Nature Portfolio

Alloimmune T cell responses have a crucial role in graft rejection. Here, the authors examine the factors that regulate T cell activation, differentiation and function in secondary lymphoid organs and in the graft, including the different pathways of allorecognition, innate–adaptive immunity crosstalk and the role of survival cytokines.

Autoimmune diseases and kidney transplantation can result in immune-mediated kidney pathology. In this Review, the authors discuss the roles of effector and regulatory B cells and the efficacy of B cell-targeting therapies in these settings.

Improved understanding of HLAs together with advances in HLA typing and antibody detection techniques have enabled transplantation of sensitized patients. Here, the authors discuss these advances as well as novel approaches to desensitization, immunomodulation and tolerance induction.

The functions of the complement system are diverse and extend beyond its role in host defence; complement activation is now known to contribute to numerous immunological, inflammatory and age-related conditions, including kidney disorders. Here, John Lambris and colleagues discuss the key activating, regulatory, and effector mechanisms of the complement system. They highlight important crosstalk connections with other regulatory systems, and, with a focus on kidney disease and transplantation, describe the involvement of complement in clinical conditions as well as promising therapeutic approaches.

Tweaking immune characteristics of donors and recipients could allow for successful cross-species organ transplantation. Here, the authors show that an anti-CD40 antibody therapy of baboons that received heart transplants from genetically modified pigs is key to their long-term survival.

Long-term immunosuppression in transplant recipients is associated with important adverse effects including increased risk of infection and malignancy. New data from the ONE Study suggests that use of cell-based medicinal products containing regulatory immune cells is a potentially useful therapeutic strategy to enable minimization of immunosuppression in these patients.

Inactivation of the major histocompatibility complex and overexpression of the transmembrane protein CD47 renders induced pluripotent stem cells invisible to the immune system of the host.