The Role Of Immunology In Organ Transplant Surgery

Immunology is the study of the immune system and is a very important branch of the medical and biological sciences, playing a crucial role in organ transplant surgery. This type of surgery involves removing a healthy organ from a donor and giving it to someone who has organ failure. It involves two surgeries that happen around the same time: One for the donor (to remove the organ) and one for the recipient (to get the organ). 

(Immunity, Inflammation and Transplantation - NIHR Cambridge Biomedical Research Centre, 2024) 

Immunology is important in organ transplantation because the immune system can recognize a transplanted organ as foreign and may attempt to reject it, which is known as organ rejection. This happens because the immune system detects that the antigens on the cells of the organ are different or “not matched.” As a result, cells from the immune system attempt to attack the transplanted tissue, which leads to organ damage and reduces its ability to function effectively.

The most common treatment to prevent organ rejection is for a patient to take immunosuppressant drugs for the rest of their lifetime. However, this approach leads to numerous side effects, including susceptibility to infection and decreased efficacy of vaccines. While this is the main approach, researchers are making discoveries that aim to improve transplant outcomes by reducing or eliminating the need for long-term immunosuppression. One particular approach was utilized by Professor Evan Scott from the University of Virginia. Scott used nanoparticles to help modify immune cell behavior so that the body is less likely to attack transplanted organs. These nanoparticles carried a specific drug, named Roxadustat, which increases the levels of HIF-2α in monocytes. Scott’s study was conducted using mice, and an increase in HIF-2α levels prevented monocytes from becoming inflammatory macrophages, which are immune cells that normally contribute to organ rejection by attacking transplanted tissue. Instead, the immune cells were less likely to trigger a damaging immune response against the transplanted heart. The mice that received higher  HIF-2α levels showed more acceptance of organ transplantation, and minimal side effects were shown, indicating that  HIF-2α levels could be a key contributor to organ rejection.

Scott’s study demonstrates the medical breakthroughs that are currently happening in the field of immunology and organ transplantation, and all the innovative strategies researchers are developing to ensure patients receive safer and more effective transplants with fewer long-term side effects. Other methods, such as modifying the immune system’s reaction to the organ or mechanically removing harmful antibodies, have also been proven to be effective. While still being developed, these approaches remain valuable in the medical field.

Written by Henry Tran at Incisionary

References

Cleveland Clinic. (2023). Organ donation & transplantation. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/11750-organ-donation-and-transplantation  

Manjili, M. H. (2025). Redefining the Immunobiology of Organ Transplantation for New Clinical Horizons. Scandinavian Journal of Immunology, 102(2). https://doi.org/10.1111/sji.70045   

Medline Plus. (2023). Transplant rejection. Medlineplus.gov. https://medlineplus.gov/ency/article/000815.htm 

Preventing organ transplant rejection. (2026, March 17). National Institutes of Health (NIH). https://www.nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection

Seal, R. (2024, September 3). Research by Biomedical Engineering Professor Could Help Prevent Organ Transplant Rejection. Virginia.edu; University of Virginia School of Engineering and Applied Science. https://engineering.virginia.edu/news-events/news/research-biomedical-engineering-professor-could-help-prevent-organ-transplant-rejection  

Stanford Health Care. (2014). Stanfordhealthcare.org. https://stanfordhealthcare.org/medical-treatments/h/heart-transplant/complications/organ-rejection.html       

Wilson, M. (2023). What is immunology? | British Society for Immunology. Www.immunology.org. https://www.immunology.org/public-information/what-immunology