Bidirectional intragraft alloreactivity drives the repopulation of human intestinal allografts and correlates with clinical outcome

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Science Immunology  07 Oct 2016:
Vol. 1, Issue 4, eaah3732
DOI: 10.1126/sciimmunol.aah3732

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Transplantation stalemate

Successful organ transplantation depends on both preventing rejection of the graft by host cells [host versus graft (HvG)] and blocking graft cells that attack the host (GvH). Zuber et al. demonstrated that a balance in this two-way alloreactivity affected clinical outcomes in organ transplant recipients. They examined gut-resident T cell turnover kinetics in human intestinal allografts and found that HvG-reactive cells persisted long-term in the graft, acquiring a tissue-resident phenotype. However, GvH-reactive cells expanded within the graft in the absence of rejection. The GvH-reactive cells may balance out the HvG-reactive cells, preventing rejection.