Immunobiological determinants in organ transplantation.

The most important development in determining successful organ transplantation has been the improved understanding of the immune response and the interactions between antigens, antibody, immune complexes, complement component, lymphocytes and macrophages. The initiation and termination of an immune response, whether cellular or humoral depends upon cellular interaction between subsets of the lymphocyte cell series and macrophages. An equilibrium between helper and suppressor T cells determines protection of the host from non-self tissue invasion, infection and neoplasia. The role of mediators, immunosuppressants, hybridomas and recombitant DNA technology are briefly considered. The relative importance of tissue typing and blood transfusion in preventing allograft rejection is considered and the role of immunological monitoring in allograft transplantation is reviewed.