Immuno path I - Transplantation Flashcards Preview

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Flashcards in Immuno path I - Transplantation Deck (16)
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1
Q

Describe direct cellular rejection

A

The donors APC cells precent HLA antigen to the host TH1 cells causing a type IV hypersensitivity.

2
Q

Describe indirect cellular rejection

A

The hosts APC infiltrate the graft and present the donors HLA molecules to the host immune system.

3
Q

Describe Ab mediated Vasculitis

A

Caused by humoral rejection in a type II hypersensitvity (Ab mediated).
This leads to opsonization and recruitment of macrophages that destroy the vasculature.

4
Q

Describe immune complex vasculitis

A

A type III hypersensitivity (Antigen-antibody complex).
Hosts Ab form complexes with donor Ag. that cause vascular damage.
This causes necrotizing vasculitis!

5
Q

What is the hallmark of Hyperacute kidney rejection?

A

Host has previously sensitized Ab due to previous transplant, pregnancy, or transfusion.
Specifically targets vasculature with Ag-Ab complexes.

6
Q

What is the hallmark of Acute kidney rejection damage?

A

Caused by CD8 and CD4 cells targeting both the tubules (CD8) and the vasculature (CD4 ab-ag)

7
Q

What lab results are commonly seen in acute kidney rejection?

A

Increased BUN levels
Decreased creatinine
Decreased urine output.

8
Q

What are the clinical manifestations of chronic kidney rejection?

A

Fibrosis with tissue ischemia, tublar atrophy, and interstitial mononuclear infiltrates.

Pt will present with anuria as well.

9
Q

What are the hallmarks of acute liver damage?

A

Rejection occurs within 40% of pt within first 3 months.

Characterized by bile duct damage and endothelitis.

10
Q

Vanishing bile duct syndrome due to cellular immune damage compounded by ischemia from Ab-mediated damage to hepatic arterioles are all hallmarks of what?

A

Hallmarks of chronic liver rejection.

11
Q

What is graft artherosclerosis of the heart?

A

Change resembling accelerated coronary artery disease.

Diffuse intimal thickening and accumulation of foamy macrophages.

12
Q

Why do patients experieincing heart graft failure not experience chest pain?

A

The cardiocytes are often denervated thus Silent MI’s are common!

13
Q

EBV associated malignancies are commonly associated with what?

A

Heart transplants due to immunosupression.

14
Q

Describe graft vs host disease.

A

The immunocompetent immune cells within the graft attack the immunosupressed cells of the host!
Tends to target skin, GI and liver.

15
Q

What is the clinical triad of acute Graft vs Host disease?

A

Dermatitis - Exfoliation or rash
Enteritis = Bloody diarrhea
Hepatitis - Hepatocyte/Bile duct necrosis leading to jaundice.
Overall damage of epithelial cells in these targets

16
Q

Describe primary graft failure/rejection

A

Rare

Host NK cells or T cells survive irradation and react against the allograft stem cells.