Spontaneous and iatrogenically augmented leukocyte chimerism in organ transplant recipients.

TL;DRAbstract

Until about 2 years ago, a transplanted organ was seen as an island in a hostile recipient sea. Then, a different perspective emerged about the reason for organ graft acceptance.1 This was based on the startling observation that donor leukocytes from these transplanted organs had migrated and survived throughout the body of the recipient for as long as three decades.2–6 The events following transplantation then were seen as a two-way cell interaction—one direction being a graft-vs-host reaction and the other the conventional host-vs-graft (rejection) reaction. Because the so-called passenger leukocytes from the graft were multilineage and derived originally from the bone marrow, the organ transplantation was in effect a mini bone marrow transplantation. At the vast interface between the coexisting donor and recipient cell populations, we suggested that changes occurred in the way each cell population viewed the other, and that these changes defined the mysterious suppressor and veto

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