Accommodation in ABO‐incompatible organ transplants

Accommodation refers to a condition in which a transplant (or any tissue) appears to resist immune‐mediated injury and loss of function. Accommodation was discovered and has been explored most thoroughly in ABO‐incompatible kidney transplantation. In this setting, kidney transplants bearing blood group A or B antigens often are found to function normally in recipients who lack and hence produce antibodies directed against the corresponding antigens. Whether accommodation is owed to changes in anti‐blood group antibodies, changes in antigen or a change in the response of the transplant to antibody binding are critically reviewed and a new working model that allows for the kinetics of development of accommodation is put forth. Regardless of how accommodation develops, observations on the fate of ABO‐incompatible transplants offer lessons applicable more broadly in transplantation and in other fields.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144607/1/xen12418.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144607/2/xen12418_am.pd