Mechanisms of Graft Rejection and Acceptance: Pathways to a New Clinical Era

ROTRF Early Morning Workshop
XXII International Congress of The Transplantation Society
Sydney Convention Centre Darling Harbour, Sydney, Australia
Bayside Auditorium B
Wednesday, August 13, 2008, 07:15–08:15

Robert B. Colvin

(ROTRF Trustee, Harvard Medical School, Boston, USA)
Gerhard Opelz
(ROTRF Trustee, University of Heidelberg, Heidelberg, Germany)

07:15 Introduction
Robert B. Colvin
07:20 Cell-Mediated Rejection: An Expanding Definition
Allan D. Kirk, Emory University, Atlanta, USA
07:35 Antibody-Mediated Rejection: The Next Frontier
Philip F. Halloran, University of Alberta, Edmonton, Canada
07:50 Identification of Operational Tolerance in Clinical Liver Transplantation
Alberto Sanchez-Fueyo, Hospital Clinic Barcelona, Barcelona, Spain
08:05 Closing Remarks
Gerhard Opelz

Workshop_programme [57 KB] PDF

The goal of this workshop is to present new insights into the mechanisms of graft rejection and acceptance that have potential relevance to clinical practice. The three speakers will link molecular pathways to pathological features in biopsies and in turn to their clinical consequences.

Although much progress has been made in the diagnosis, treatment and prevention of T-cell-mediated acute graft injury, recent evidence points to other components, such as the innate immune system, that contribute to graft rejection both by direct injury and by promoting an alloresponse. Full understanding of these alternative pathways will likely lead to innovative therapies.

Over the last several years, alloantibodies have finally been recognised as a major barrier to successful organ transplantation, not only in terms of acute rejection in presensitised patients, but more broadly in all patients for long-term graft survival. The pathological and clinical features of early and late antibody-mediated rejection will be described and complemented with new molecular markers that reveal potential pathogenetic mechanisms through microarray detection of gene expression in biopsies.

The long-standing goal of clinical transplantation to control mechanisms of graft rejection by harnessing immunoregulatory processes will be the third topic of this workshop. The emerging lessons from mouse and human studies will be discussed with particular reference to liver transplantation and the search for a non-invasive diagnostic signature capable of predicting tolerance before drug withdrawal.