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Gary Gurka, MD; Ross E. Rocklin, MD

JAMA. 1987;258(20):2983-2987.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

ONE OF the greatest mysteries yet to be unraveled in biology is the mechanism by which the fetus, which is essentially an allograft, is able to survive the immunologic defenses of the mother without being rejected. That a successful pregnancy so often is the outcome seems even more remarkable, since it defies the basic tenets of the field of transplantation immunology.

Metchnikoff first noted in 1882 that starfish had an intrinsic ability to differentiate self from nonself and, in their identification of that which was foreign, mounted a vigorous reaction locally to eliminate the invader. One might wonder how an embryo, which receives 50% of its genetic code from the father, can be housed in a womb that may already be primed to destroy it. Medawar¹ hypothesized in 1954 several mechanisms for the survival of the fetal allograft: (1) the fetus is not immunogenic and therefore cannot be detected; . . . [Full Text PDF of this Article]

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