WILL TOLERANCE BECOME A CLINICAL REALITY

The goal of transplant physicians is to create a state of antigen-spec ific tolerance in the recipient, whereby the graft is not rejected and the patient will not need a lifetime of medical therapy. Although the immunosuppressive medications used are effective in lowering the inci dence of rejection, they produce significant side effects and do not i nduce a state of transplantation tolerance. Progress toward inducing t ransplantation tolerance has been made in animal models, primarily by the exploitation of the natural mechanisms that vertebrates have to ma intain self-tolerance. These same strategies are being employed in cli nical trials and consequently are promising and challenging for the fu ture.