Immunosuppressive Therapy and Tolerance of Organ Allografts

In this issue of the Journal, three articles describe several organ-transplant recipients in whom allografts have maintained good function for up to 5 years without immunosuppressive treatment.13 In two articles concerning combined kidney and hematopoietic stem-cell transplantation, the authors attributed the successful outcome in their patients to the cotransplantation of donor stem cells.1,2 The third report, by Alexander et al., concerns a young girl who received a completely HLA-mismatched liver from a deceased male donor but did not receive a donor stem-cell infusion.3 The cause of the fulminant hepatic failure with which the patient presented was never firmly . . .