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Review
. 2022 Jul 27:13:931251.
doi: 10.3389/fimmu.2022.931251. eCollection 2022.

Novel approaches for long-term lung transplant survival

Affiliations
Review

Novel approaches for long-term lung transplant survival

Cynthia L Miller et al. Front Immunol. .

Abstract

Allograft failure remains a major barrier in the field of lung transplantation and results primarily from acute and chronic rejection. To date, standard-of-care immunosuppressive regimens have proven unsuccessful in achieving acceptable long-term graft and patient survival. Recent insights into the unique immunologic properties of lung allografts provide an opportunity to develop more effective immunosuppressive strategies. Here we describe advances in our understanding of the mechanisms driving lung allograft rejection and highlight recent progress in the development of novel, lung-specific strategies aimed at promoting long-term allograft survival, including tolerance.

Keywords: acute cellular rejection (ACR); antibody-mediated rejection (AMR); chronic lung allograft dysfunction (CLAD); ex vivo lung perfusion (EVLP); immunosuppression; lung transplantation; mesenchymal stromal cells (MSCs); tissue-resident memory T-cells.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Novel approaches to achieve long-term lung transplant survival.
Figure 2
Figure 2
Pathology and chest radiographs from three tolerant NHP lung transplant recipients that underwent delayed donor bone marrow transplantation. Shown are photomicrographs (hematoxylin and eosin (H&E) staining) of lung biopsies performed at the time of euthanasia and chest radiographs obtained at indicated time points from each recipient. The chest radiographs of NHP recipients M2411, M912, M4012 displayed well-aerated lung allografts in the left thoracic space. No signs of rejection were seen in the lung graft biopsy of M2411, M912, and M4012. Adapted from (181). BMT, Bone marrow transplantation.

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