Introduction

The dream of replacing a diseased human organ with one from a dead person is ancient: legend states that Saints Cosmas and Damien in the fourth century A.D. miraculously transplanted a leg from a dead man. Such a creature would be a chimera, named after the "mingled monster" of Homer's Iliad. The scientific study of the biology of transplanting tissue dates to the first years of this century, when Little and Tyzzer1 defined the Laws of Transplantation, paraphrased as: "isografts succeed; allografts are rejected." The clinical practice of transplantation is governed by these laws. This chapter introduces the immunologic events in transplantation, and in particular the molecular basis of these events, to be supplemented by reviews.2-14 Table 1.1 summarizes our approach, and Table 1.2 presents some useful terms. A recurrent theme is the "allo" relationship, which describes the relationship between two members of the same species who are not genetically identical. Thus we can describe alloantigens, allografts, and alloantibody.

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