Implications for the usage of the left lateral liver graft for infants ≤10 kg, irrespective of a large-for-size situation--are monosegmental grafts redundant?

Organ donor shortage for infant liver transplant recipients has lead to an increase in splitting and living donation. For cases in which even transplantation of the left lateral graft (Couinaud's segments II + III) results in a "large for size situation" with an estimated graft body weight ratio (GBWR) of >4%, monosegmental liver transplantation was developed. This, however, bears complications because of greater parenchymal surface and suboptimal vascular flow.

[Living donation liver transplantation in children].

Liver transplantation is the first-line therapy for children with acute and chronic hepatic failure, metabolic liver diseases and liver tumors. As most of the children with end-stage liver disease are very small in stature the resources of compatible organs of deceased donors are limited. Living liver donation was able to nearly eliminate waiting list mortality with excellent patient and graft survival.

WOFIE stimulates regulatory T cells: a 2-year follow-up of renal transplant recipients.

Background: Initial interruption of immunosuppression for 72 hr was analyzed in renal transplant recipients according to Calne et al.'s "window of opportunity for immunologic engagement" (WOFIE) concept.

Methods: This pilot study was designed as a randomized, open-label, prospective trial of 40 recipients (20 in the WOFIE group, 20 in the control group) of cadaveric kidney transplants who were followed up for 2 years.

Multipotent cells of monocytic origin improve damaged heart function.

Recently, we generated cells with multipotent properties from blood monocytes that in vitro differentiate into various somatic cell types. This experimental study investigated whether these programmable cells of monocytic origin (PCMO) succeed to restore left ventricular function after myocardial infarction (MI). PCMO were generated from monocytes by exposition to RPMI medium containing M-CSF and IL-3 for 6 days.

[Significance of allopeptide-induced expression of Fas ligand (FasL) in parenchyma of allogenic heart transplants as the cause of donor-specific tolerance induction].

This study proves the tolerogenicity of polymorphic allopeptides. Combined administration of peptides derived from the alpha 1 (intrathymal) and the alpha 2 (intraperitoneal) helical region of the donor RT1.A(a) molecule induced specific tolerance in a rat model of cardiac allotransplantation.

Tolerance-inducing strategies in transplantation surgery-current status and perspectives.

Background: Life-long immunosuppressive medication has to be administered to the majority of solid-organ recipients after transplantation of genetically mismatched organs in order to circumvent acute graft loss due to alloreactive rejection responses triggered by the host's immune system. However, life-long suppression of the immune system implicitly limits the host's ability to respond appropriately to infectious, fungal and carcinogenic threats. Simultaneously non-targeted inhibition of immunological defense mechanisms coincides with substantial morbidity and mortality for the host.

WOFIE synergizes with calcineurin-inhibitor treatment and early steroid withdrawal in kidney transplantation.

Background: According to the window of opportunity for immunologic engagement (WOFIE) concept, as designed by R. Calne, the authors prospectively analyzed the effect of a 72-hr immunosuppressive window on graft function in renal transplant recipients.

Methods: Immunosuppressive therapy comprised tacrolimus (trough levels, 5-8 ng/mL after day 8 posttransplantation), daclizumab (1 mg/kg body weight at day 0 and 2, 4, 6, and 8 weeks posttransplantation), mycophenolate mofetil (MMF) (1-2 g/day), and prednisolone.

Spontaneous tolerance: experience with the rat liver transplant model.

Soluble major histocompatibility complex (MHC) class I antigens released from hepatocytes and the passenger leukocyte population of the liver allograft have both been considered as important contributors for spontaneous liver tolerance upon allogeneic transplantation into fully MHC-mismatched hosts. This study was conducted to delineate the role of "passenger leukocytes" (PL) as well as local intra-graft defence mechanisms of long-term accepted liver allografts in more detail. Orthotopic liver transplantation was performed in male inbred rats as follows (n = 4-6): (i) Lewis (LEW; RT1.

Future strategies for tolerance induction: a comparative study between hematopoietic stem cells and macrophages.

So far, clinical benefit of hematopoietic stem cell induced donor-specific tolerance across major histocompatibility complex (MHC) barriers was hampered by either graft rejection or graft-versus-host disease. An alternative approach focuses on the use of donor-derived cells that bear an inherent mechanism to circumvent allospecific rejection upon injection into non-immunosuppressed hosts. Using a myeloablative conditioning model in the rat, full donor chimeric recipients were generated and their potential to induce long-term cardiac allograft survival was compared with the fate of grafts transferred to non-immunosuppressed host rats pretreated with donor-macrophages derived from the peritoneal cavity in the LEW to DA inbred strain combination.

Embryonic stem cells share immune-privileged features relevant for tolerance induction.

Continuous immunosuppressive treatment allows the majority of transplant recipients to accept their donated organ and prevent acute graft rejection. However, life-long suppression of the immune system to respond appropriately to infectious, fungal, and carcinogenic threats coincides with substantial morbidity and mortality for the host. Thus for the past five decades research in the field of transplantation medicine has focused on innovative strategies to induce graft tolerance to donor alloantigens, a state in which the recipient's lymphocytes have learned to accept the foreign organ or tissue as "self" without the need of permanent immunosuppression.

WOFIE augments the immunosuppressive potency of FK-506. Window of opportunity for immunological engagement.

Unlabelled: Bidirectional recognition of donor- and recipient-derived immunocompetent cells has been proven to play a pivotal role for the induction of long-term unresponsiveness to allogeneic grafts. This study investigated the fate of heterotopic heart grafts with respect to the timing of subtherapeutic doses of FK-506 and with respect to the time point and type of donor antigen application, leaving space for mutual adaptation of alloreactive lymphocytes, designated as the 'WOFIE-concept' (window of opportunity for immunological engagement), originally described by R Calne.

Methods: Heterotropic heart transplantation was performed using male DA (RT1.

Different in vivo tolerogenicity of MHC class I peptides.

The efficacy of MHC class I-derived peptides to induce tolerance was tested in a cardiac transplantation model. Two 25-mer peptides from the polymorphic region of the DA class I molecule (RT1.Aa) were synthesized by F-moc chemistry and injected intrathymically or intraperitoneally into LEW (RT1.