Autoimmune Reactivity in Graft Injury: Player or Bystander?

Organ transplantation is the only viable treatment for several end-stage organ failures. However, chronic rejection prevents long-term graft survival. Traditionally, this rejection was attributed to the development of alloimmunity in transplant patients. However, recent evidence suggests that autoimmunity plays a larger role in chronic rejection of certain organ transplants, than alloimmunity. In this review, we will focus on the history of autoimmunity in solid organ transplantation and look at the collagen type V, Kα1 tubulin, vimentin, cardiac myosin, and heat shock proteins as classical examples of autoantigens in organ transplantation. We will also look at some of the recent reports looking at the mechanisms of autoimmunity and try to provide answers to some of the age-old questions in autoimmunity. © 2015, Springer International Publishing AG.