Immunologic aspects of small bowel transplantation

The small intestine differs from other transplanted organs by its heavy septic content and its association with a specialized lymphoid system able to target immune responses into the intestinal mucosa. This review focuses on the immunologic singularities of the intestine, describes the immunologic features of intestinal rejection, and analyzes the immunologic strategies currently developed in experimental models to improve tolerance to intestinal grafts, with emphasis on liver-induced tolerance and targeting of receptors involved in T-cell activation.