Johns Hopkins University School of Medicine
Approximately 6 million people in the United States have some degree of impaired kidney function, and more than 400,000 individuals suffer from end-stage renal disease (ESRD). Renal transplantation is the treatment of choice for ESRD, with approximately 14,000 kidney transplants performed in the United States and 50,000 worldwide each year. Except in the case of identical twins, the foreign graft antigens will activate the humoral and cellular arms of the immune response, which will in turn lead to allograft rejection. The events leading to allograft rejection are a consequence of the donor antigen recognition by the recipient's T cells. This is based on the recipient's recognition of foreign peptides associated with the major histocompatibility complex (MHC) class 1 and 2 molecules on the cell surface of transplanted organs and the graft-derived peptides bound to self MHC. The transplantation immune response comprises virtually all aspects of immune function.
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