Since the 1960s, heart and lung transplantation has remained the optimal therapy for patients with end-stage disease, extending and improving quality of life for thousands of individuals annually. Expanding donor organ availability and immunologic compatibility is a priority to help meet the clinical demand for organ transplant. While effective, current immunosuppression is imperfect as it lacks specificity and imposes unintended adverse effects such as opportunistic infections and malignancy that limit the health and longevity of transplant recipients. In this review, we focus on donor macrophages as a new target to achieve allograft tolerance. Donor organ-directed therapies have the potential to improve allograft survival while minimizing patient harm related to global suppression of recipient immune responses. Topics highlighted include the role of ontogenically distinct donor macrophage populations in ischemia-reperfusion injury and rejection, including their interaction with allograft-infiltrating recipient immune cells and potential therapeutic approaches. Ultimately, a better understanding of how donor intrinsic immunity influences allograft acceptance and survival will provide new opportunities to improve the outcomes of transplant recipients.

中文翻译：

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供体巨噬细胞在心脏和肺移植后的作用。


自 20 世纪 60 年代以来，心肺移植一直是终末期疾病患者的最佳治疗方法，每年延长并改善了数千人的生活质量。扩大供体器官的可用性和免疫相容性是帮助满足器官移植临床需求的首要任务。虽然有效，但目前的免疫抑制并不完善，因为它缺乏特异性，并会产生意想不到的不利影响，例如限制移植受者健康和寿命的机会性感染和恶性肿瘤。在本次综述中，我们重点关注供体巨噬细胞作为实现同种异体移植耐受的新目标。供体器官定向疗法有可能提高同种异体移植物的存活率，同时最大限度地减少与受体免疫反应的整体抑制相关的患者伤害。重点讨论的主题包括个体发育不同的供体巨噬细胞群在缺血再灌注损伤和排斥反应中的作用，包括它们与同种异体移植物浸润的受体免疫细胞的相互作用以及潜在的治疗方法。最终，更好地了解供体内在免疫如何影响同种异体移植物的接受和存活将为改善移植受者的结果提供新的机会。