{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:04:58Z","timestamp":1791515098522,"version":"4.3.4"},"reference-count":170,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2017,6,23]],"date-time":"2017-06-23T00:00:00Z","timestamp":1498176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,13]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Ever since its first application in clinical medicine, scientists have been urged to induce tolerance towards foreign allogeneic transplants and thus avoid rejection by the recipient's immune system. This would circumvent chronic use of immunosuppressive drugs (IS) and thus avoid development of IS-induced side effects, which are contributing to the still unsatisfactory long-term graft and patient survival after solid organ transplantation. Although manifold strategies of tolerance induction have been described in preclinical models, only three therapeutic approaches have been utilized successfully in a still small number of patients. These approaches are based on (i) IS withdrawal in spontaneous operational tolerant (SOT) patients, (ii) induction of a mixed chimerism and (iii) adoptive transfer of regulatory cells. Results of clinical trials utilizing these approaches show that tolerance induction does not work in all patients. Thus, there is a need for reliable biomarkers, which can be used for patient selection and post-therapeutic immune monitoring of safety, success and failure. In this review, we summarize recent achievements in the identification and validation of such immunological assays and biomarkers, focusing mainly on kidney and liver transplantation. From the published findings so far, it has become clear that indicative biomarkers may vary between different therapeutic approaches applied and organs transplanted. Also, patient numbers studied so far are very small. This is the main reason why nearly all described parameters lack validation and reproducibility testing in large clinical trials, and are therefore not yet suitable for clinical practice.<\/jats:p>","DOI":"10.1111\/cei.12988","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T12:35:08Z","timestamp":1495110908000},"page":"158-170","source":"Crossref","is-referenced-by-count":22,"title":["Immune monitoring as prerequisite for transplantation tolerance trials"],"prefix":"10.1093","volume":"189","author":[{"given":"K","family":"Behnam Sani","sequence":"first","affiliation":[{"name":"Institute of Medical Immunology, Charit\u00e9 Universitaetsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8166-8579","authenticated-orcid":false,"given":"B","family":"Sawitzki","sequence":"additional","affiliation":[{"name":"Institute of Medical Immunology, Charit\u00e9 Universitaetsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,6,23]]},"reference":[{"key":"2021120808101424200_cei12988-bib-0001","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1111\/j.1600-6143.2011.03539.x","article-title":"Solid organ allograft survival improvement in the United States: the long-term does not mirror the dramatic short-term success","volume":"11","author":"Lodhi","year":"2011","journal-title":"Am J Transplant"},{"key":"2021120808101424200_cei12988-bib-0002","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jhep.2015.10.006","article-title":"EASL clinical practice guidelines: liver transplantation","volume":"64","year":"2016","journal-title":"J Hepatol"},{"key":"2021120808101424200_cei12988-bib-0003","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1038\/ki.2009.377","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary","volume":"77","author":"Kasiske","year":"2010","journal-title":"Kidney Int"},{"key":"2021120808101424200_cei12988-bib-0004","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.2165\/11319260-000000000-00000","article-title":"Immunosuppressive drugs in kidney transplantation: impact on patient survival, and incidence of cardiovascular disease, malignancy and infection","volume":"69","author":"Marcen","year":"2009","journal-title":"Drugs"},{"key":"2021120808101424200_cei12988-bib-0005","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1159\/000351648","article-title":"Calcineurin inhibitor nephrotoxicity: a review and perspective of the evidence","volume":"37","author":"Issa","year":"2013","journal-title":"Am J Nephrol"},{"key":"2021120808101424200_cei12988-bib-0006","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1111\/j.1600-6143.2009.02639.x","article-title":"Recent developments in kidney transplantation \u2013 a critical assessment","volume":"9","author":"Womer","year":"2009","journal-title":"Am J Transplant"},{"key":"2021120808101424200_cei12988-bib-0007","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.trre.2015.01.003","article-title":"Circulating biomarkers of tolerance","volume":"29","author":"Girmanova","year":"2015","journal-title":"Transplant Rev"},{"key":"2021120808101424200_cei12988-bib-0008","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1600-6143.2011.03840.x","article-title":"Understanding the causes of kidney transplant failure: the dominant role of antibody-mediated rejection and nonadherence","volume":"12","author":"Sellares","year":"2012","journal-title":"Am J Transplant"},{"key":"2021120808101424200_cei12988-bib-0009","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/j.1432-2277.2008.00748.x","article-title":"Can immune monitoring help to minimize immunosuppression in kidney transplantation?","volume":"22","author":"Ashton-Chess","year":"2009","journal-title":"Transpl Int"},{"key":"2021120808101424200_cei12988-bib-0010","doi-asserted-by":"crossref","first-page":"3296","DOI":"10.1111\/j.1600-6143.2012.04249.x","article-title":"The natural history of clinical operational tolerance after kidney transplantation through twenty-seven cases","volume":"12","author":"Brouard","year":"2012","journal-title":"Am J Transplant"},{"key":"2021120808101424200_cei12988-bib-0011","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1056\/NEJMoa1506027","article-title":"Belatacept and long-term outcomes in kidney transplantation","volume":"374","author":"Vincenti","year":"2016","journal-title":"N Engl J Med"},{"key":"2021120808101424200_cei12988-bib-0012","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/SLA.0000000000000969","article-title":"Is minimal, [almost] steroid-free immunosuppression a safe approach in adult liver transplantation? 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