Idogen’s technology also has potential for development as a treatment to reduce the risk of organ and cell rejection after transplantation. The basic principle in this case is to “teach” the patient’s immune system to recognize and tolerate the transplanted organ rather than attack it. This could eventually reduce the need after transplantation for the current, often lifelong, treatment with preparations that inhibit all types of immune system functionality. The greatest and most serious complication is when the transplant recipient’s immune system attacks, destroys and rejects the donated organ. To prevent this, the transplanted patients – with few exceptions – are given lifelong treatment with a combination of immunsuppressive drugs that suppress the immune defense, but at the same time the risk of undesirable side effects such as cancer and infections increases. While the number of patients who retain a functional transplanted kidney during the first year after transplantation has increased in recent decades, there has not been any decisive improvement in the long-term survival of transplants. [1, 2]
The company is therefore of the opinion that transplantation is a therapeutic area with a significant medical need. Idogen’s tolerogenic cell therapy could provide possibilities for both improving transplant survival and reducing the need for and use of immunosuppressive drugs.
Kidney transplantation is the most common type of organ transplantation, and the number of kidney transplants has increased over the last few years, from approximately 72,000 globally in 2010 to approximately 100,000 in 2019 . In 2020, significantly fewer kidney transplantations – approximately 20,000 – were conducted globally. The reason for this was the COVID-19 pandemic, which prevented the medical sector from performing these operations . This decline was also noted in Sweden, but only with a reduction of about 50 operations. 
In Europe, the number of kidney transplants amounted to approximately 22,000 in 2010 and increased to more than 28,000 in 2019, an increase of approximately 30% over a ten-year period. The figure for North and South America increased from approximately 22,800 transplantations to approximately 39,500 during the same period, an increase in excess of 40% for the period. These regions also saw a drastic reduction during 2020 due to the COVID-19 pandemic, with levels comparable to the beginning of the decade. 
An average calculated on Idogen’s potential markets shows that approximately 26% of all kidney transplantations occur from living donors.3 This is the group of transplants that Idogen will initially focus on. Access to a related living donor gives time for the manufacture of the recipient’s cell therapy ahead of organ harvest and transplantation.
The market for IDO T for kidney transplantations with a living donor is estimated to have a potential annual market value of approximately USD 2–4 billion. 
Prevention of organ rejection in kidney transplantation
The market for IDO T for kidney transplantations with a living donor is estimated to have a potential annual market value of approximately USD 2–4 billion.
Addressable market, kidney transplantation
Of the total market of approximately 100 000 kidney transplantations per year, 44 000 patients are estimated to receive transplants in Idogen´s addressable markets (North America, Europe and Japan). Of these, 26% are performed with living donors – 11 252 per year.