Revisiting tolerance induction by donor cell priming

Purpose of review Donor-specific transfusion is one of the most potent approaches to induce tolerance to vascularized organs and has been extensively studied in the rat. Following donor-specific transfusion, immune activation and suppressive mechanisms involving T cells, dendritic cells and immunosuppressive cytokines have been described in tolerant recipients. Recent Findings Recent data on the donor-specific transfusion effect have led to the development of new concepts concerning this tolerance induction phenomenon, particularly concerning the role of the transplant itself and the coexistence of regulatory T cells able to transfer tolerance and chronic rejection lesions in the long-term surviving grafts. Summary Reviewing these mechanisms would help in the quest to improve strategies to achieve tolerance in the clinic.