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Over the last half a century, there have been innumerable advances in our understanding of the human immune system. We now have a better understanding not only of the ways our innate and adaptive immune pathways interact to seek out and control infection and malignancy, but we are closer to understanding some of the control mechanisms behind tissue rejection. Organ allograft rejection, with consequent loss of graft function, remains one of the most challenging problems facing solid organ allotransplantation. Developments in therapeutic immunosuppression have enabled us to minimize rejection risk and improve the life expectancy and graft survival for many of our patients, but at a cost: the more intense the immunosuppression, typically the greater the infection risk. Ultimately, the field continues to work towards ways of achieving organ tolerance whereby both rejection risk and the threats of infection are minimized.

DOI: 10.1007/978-3-030-01751-4_2-1