Abstract

Immune tolerance is a critical factor in the success of solid organ transplantation, as it enables the recipient's immune system to accept the transplanted organ without eliciting a rejection response. Recent advances in transplantation immunology have focused on understanding the mechanisms underlying immune tolerance, including the induction of tolerance, maintenance of long-term graft survival, and prevention of rejection. This review examines the molecular pathways involved in tolerance, highlighting the role of regulatory T cells, immune checkpoint molecules, and the role of antigen-presenting cells in modulating the immune response. Moreover, the development of immunosuppressive therapies that selectively promote tolerance while minimizing the risk of infection and malignancy is discussed. The review also explores cutting-edge strategies, such as cellular therapy and gene editing, which hold promise for achieving operational tolerance in transplant recipients. Despite these advancements, the clinical application of immune tolerance remains challenging, and further research is required to optimize these therapies for broader clinical use.