BYPASSING THE HLA SYSTEM IN ORGAN TRANSPLANTATION: OPPORTUNITIES TO ACHIEVE UNIVERSAL COMPATIBILITY VIA FULL SUPPRESSION AND ARTIFICIAL IMMUNOBIOCODING

This study explores innovative strategies to overcome HLA incompatibility in organ transplantation, a major cause of graft rejection. Two promising approaches are highlighted: CRISPR/Cas9-mediated deletion of HLA genes and artificial immunobiocoding to create universal donor cells. Gene editing to suppress classical HLA expression, while preserving non-classical molecules like HLA-E, has shown reduced immune recognition in preclinical models. Additionally, the expression of immunomodulatory molecules such as PD-L1 and CD47 further enhances immune evasion. Ongoing clinical efforts, including iPSC banks and universal stem cell lines, indicate substantial progress toward safer, more accessible transplantation without long-term immunosuppression.