The Molecular Immunology of Acute Rejection: An Overview
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Transplantation immunology began as an empirical science but can now take its place as a discipline with a strong theoretical and molecular basis. The Laws of Transplantation, formulated at the beginning of this century by Little and Tyzzer, can be paraphrased as ‘Isografts succeed; allografts fail’. As the century closes, the molecular basis of those laws is emerging. Achieving the full potential of the advances in immunology requires that transplant clinicians learn the molecular basis for their art and participate in the development and testing of new hypotheses; and that immunologists assess their ideas against the real world of the transplant recipient. This review will highlight areas of recent progress in transplant immunology and point out areas where clinical events remain poorly explained. Because many excellent reviews are available, we will primarily quote articles after 1990. Our approach to transplantation biology at the molecular level is summarized in Table 1.