Immunology 3: Transplantation Flashcards Preview

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Flashcards in Immunology 3: Transplantation Deck (36)
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1

Recall 3 organs that mat be transplanted for the purpose of saving life

Liver
Heart
Small bowel

2

Give an example of a life-enhancing organ transplant

Kidneys

3

What is an autograft?

Transplant from the same individual

4

Give one potential use for stem cells in organ transplantation

Stem cells can be stimulated to differentiate into a human nephron

5

What is a transplant between genetically-identical individuals called?

Isografts

6

What is an allograft?

Transplantation betwen different organs of the same species

7

Recall examples of free cells that may be transplanted?

Bone marrow
Pancreatic islets

8

Recall 3 examples of non-solid-organ transplantation

Blood
Tendons
Bone

9

What are the 2 classes of deceased organ donor?

After brain death
After cardiac death

10

When is brain death most likely to occur?

When someone suffers a brain event (eg stroke) that causes death in hospital, and doctors keep their heart beating and their lungs ventilated mechanically

11

Summarise the process of organ transplantation ABD

Heartbeat and ventilation maintained mechanically
Brainstem function checked to be nil
Organs extracted and put in cool ischaemic environment

12

What is the main advantage of organ donation ABD over ACD?

No ischaemic damage

13

Which organs are most suitable for donation ACD?

Kidneys

14

Recall the exclusion criteria for transplantation of an organ?

Viral infection
Malignancy
Drug abuse
Disease

15

What is a xenograft?

Transplant between individuals of a different species

16

Give an example of where xenograft is used

Porcine/ bovine heart valves

17

What is a composite graft? Give an example

Many tissues
eg face

18

What elements of equity are considered to decide who receives a transplant organ?

Time on waiting list
Imminence of death

19

What elements of efficiency are considered to decide who receives a transplant organ?

Best use of organ in terms of survival and graft survival

20

Which organisation is responsible for weighing up equity and efficacy of a transplant?

NHSBT (NHS Blood and Transplant)

21

Homozygosity between donor and recipient is important for which genes?

HLA-B/ HLA-DR

22

How is HLA mismatch noted?

As ratio: number of differences between HLA-A/B/DR
Eg MM 1:2:0

23

Recall the sequence of events leading to organ rejection when the wrong blood group is transplanted

Complement activation
Phagocytes recruited
Endothelium disrupted
Platelets aggregate
Thrombosis

24

How are organ-rejections classified?

Hyperacute: already sensitised
Acute: rapid de novo antibody synthesis
Chronic: slow reaction

25

Which T cells are released first in a T cell-mediated rejection of an organ?

CD4+

26

How do CD8+ T cells induce apoptosis?

Granzyme
Fas-L

27

What sort of antibodies may be problematic in transplant?

Anti-graft HLA
Ant-graft blood antigen

28

What is the main target site of anti-graft antibodies?

Endothelium

29

Recall the liver-based evidence of transplant rejection

Elevated creatinine
pain
fever
LFTs
fluid retention

30

What is the main risk of being an organ donor?

Major perioperative morbidity