In Search of the Elusive Holy Grail: the Mechanisms and Prospects for Achieving Clinical Transplantation Tolerance

In 1953, Billingham, Brent and Medawar published their famous paper reporting the first successful induction of transplantation tolerance using experimental manipulation. During the 48 years that have passed since then, perhaps as many as 48 additional strategies for tolerance induction have been described in small animal models. Nonetheless, clinical organ transplantation is still performed with nonspecific immunosuppressive drugs, and no tolerance-inducing protocol has yet moved into large clinical trials.