Lessons from cardiac transplantation in infancy.

Besides correcting devastating pathophysiology, cardiac transplantation in infancy offers an incomparable model for exploring the structure and function of the immune system. Infants and young children have relatively few memory B cells and T cells. Hence, the response of the young to allotransplantation better represents a primary immune response and may be better suited to testing spontaneous tolerance. Those who undergo cardiac transplantation in infancy are also unique because they are often subjected to thymectomy and depletion of mature T cells. These subjects can have a dramatic contraction of T cell diversity, allowing the testing of how diversity contributes to function.