This is an application for competitive renewal of a program project grant which has been active for 24 years. It involves many investigators and many different projects all relating to the improvement of the results of organ transplantation. It is a complex grant but can be easily understood. The grant has been divided into two major sections: 1. CLINICAL PROJECTS OF HUMAN ORGAN TRANSPLANTATION and 2. EXPERIMENTAL PROJECTS UTILIZING ANIMALS OR IN VITRO TECHNIQUES This organization persists in this application for competitive renewal. The basic overall OBJECTIVES have been to: (A) Analyze and isolate the clinical problems involved in organ transplantation and precisely document clinical laboratory correlations. (B) Organize clinical trials based on available data to solve clinical problems. (C) Generate experimental approaches to help solve clinical problems. Within these objectives, all projects are organized into three essential AIMS:
AIM 1 : TO PREVENT ORGAN DESTRUCTION: This includes not only immunological manipulations designed to prevent rejection but also those designed to prolong patient survival and to modify or control drug toxicity and recurrent disease.
AIM 2 : TO COUNTERACT INFECTION: The focus here is on cytomegalovirus.
AIM 3 : TO MAXIMIZE REHABILITATION: The focus here is on the psychosocial effects of clinical transplantation.
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