Emerging issues in transplantation

Rupert Oberhuber

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Guangxiang Liu,

Guangxiang Liu

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Timm Heinbokel,

Timm Heinbokel

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Stefan G. Tullius,

Stefan G. Tullius

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Rupert Oberhuber,

Rupert Oberhuber

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Guangxiang Liu,

Guangxiang Liu

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Timm Heinbokel,

Timm Heinbokel

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Stefan G. Tullius,

Stefan G. Tullius

Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA

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Book Editor(s):Xian Chang Li MD, PhD,

Xian Chang Li MD, PhD

Professor of Immunology/Surgery Director

Weill Cornell Medical College, Cornell University, New York, NY

Immunobiology and Transplant Science, Houston Methodist Hospital, Texas Medical Center, Houston, TX, USA

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Anthony M. Jevnikar MSc, MD, FRCP(C),

Anthony M. Jevnikar MSc, MD, FRCP(C)

Professor of Medicine, Surgery, Microbiology & Immunology

Western University, Director Transplantation Nephrology, Director Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Centre, London, ON, Canada

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First published: 12 September 2015

https://doi.org/10.1002/9781119072997.ch14

Summary

Organ transplantation has evolved over a short period to an evidence-based therapeutic approach, providing enormous benefits for patients with end-stage organ failure. With concerns of reduced organ availability and quality, it is critical to explore the clinical implications of using marginal donor organs. This chapter discusses the mechanisms of senescence and discusses proper treatment options during organ perfusion, organ preservation, and in the early post-transplant period. With an ever-increasing demand for organ transplants, alternative approaches to address organ shortage are once again experiencing strong interest. Xenotransplantation has gained momentum along with the development of bio-artificial organs. These two fields merging as xenogeneic organs are being explored as a means to provide scaffolds for bioengineered organs, reconstituted with human stem cells. The impact of immunosenescence in the elderly on alloimmune responses, immunosuppressive therapy, incidence of drug-related complications, and overall transplant outcomes remains poorly understood.

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Transplant Immunology