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The Allograft Immune Response

University of Pennsylvania Medical Center

Abraham Shaked, MD, PhD

University of Pennsylvania Medical Center, shake{at}mail.med.upenn.edu

This article describes the interaction between the host immune system and the allograft. Histocompatibility antigens, in particular, the class I and II major histocompatibility antigens (MHC), distinguish self and non-self. Recipient T cells recognize MHC antigens displayed on the surface of antigen-presenting cells to trigger T cell activation and proliferation. CD4+Tcells, also known as helper Tcells, are the dominant phenotype in acute cellular allograft rejection. CD8+ T cells, known as cytotoxic T cells, are responsible for cell-directed cytotoxicity. Under the influence of selectins, integrins, and the immunoglobulin superfamily, recipient leukocytes migrate to the graft. Macrophages activated by CD4+ Tcells release cytotoxic cytokines that cause tissue destruction. The types of allograft rejection are hyperacute, acute cellular, and chronic ductopenic.

Key Words: liver transplantation • histocompatibility antigens • Th • CD4 T cells • CD8 T cells

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