transplant

Question 1

autograft

Answer 1

come from yourself
-no rejection

Question 2

syngraft/ isograft

Answer 2

graphs between 2 genetically identical people

Question 3

allograft

Answer 3

graph between members of the same species
-not identical
-can be rejected

Question 4

xenograft

Answer 4

graph comes from a different species
-Can be rejected

Question 5

main goal of transplant

Answer 5

last as long as possible

Question 6

hyperacute or white rejection

Answer 6

• Happen within 24 hrs after transplanted tissue
  -Usually due to pre formed antibodies already circulating in person’s tissue

ex. ABO rejection

Question 7

acute rejection

Answer 7

-T-cell mediated - cytotoxic t cells are main players
- Happens within weeks to months

type 4 sensitivity

Question 8

most common kind og rejection

Answer 8

acute rejection

Question 9

chronic

Answer 9

-hapens years later
-type 3 or 4

• Due to soluble antibodies that get formed to shedded antigens

Question 10

how does chronic rejection happen

Answer 10

Antigens are shed of graft into bloodstream, get antigen-antibody complex and fall on the graft– leads to necrosis

also can happen from non-immunological reasons
-drinking after liver transplant

Question 11

2 pathways of recognizing

Answer 11

-direct allorecognition
-indirect method

Question 12

direct allorecognition

Answer 12

-recognize intact HLA molecules - no processing
-TCR on recipient recognizes this on donor

host cells are CD8 – MHC 1

Question 13

indirect method

Answer 13

-host cells recognize processed HLA
-presented by APC to CD4 cell – MHC 2

Question 14

most common kind of recognition

Answer 14

indirect method

Question 15

when have a donor what test do you perform

Answer 15

mixed lymph reaction test

-determines if donor and recipient have similar HLA antigens on lymphs

Question 16

HLA class 1 uses

Answer 16

T cells

Question 17

HLA class 2 antigen use

Answer 17

B cell

Question 18

process of Mixed Lymphocyte Reaction Test

Answer 18

take donor cells and iridate them so no reaction (only want recipient to react)

mix donor and recipient cells

if same antigens- no reaction

if different– reaction

see this by adding radioactive isotope

more reactivity = greater disparity

Question 19

matches we look for in histocompatibility testing

Answer 19

HLA A, B, C, DR, DQ

Question 20

Complement dependent cytotoxicity test

Answer 20

includes panels of known Abs because we are looking for patients Ags

-if there is a response, complement will come in and destroy antigen
-add vital stain
-dead cells more permeable and take up stain

Question 21

class 1 uses

Answer 21

T and B cells

Question 22

Class 2 uses

Answer 22

B cells

Question 23

flow cytometry

Answer 23

tag antigens or Abs with a fluorochrome

Question 24

HLA Ab screening- multiplex

Answer 24

• Multiplex assay
• Coated on microbeads
  -Fluorescence color

Question 25

#1 kind of transplants

Answer 25

kidney -live donors

Question 26

criteria for kidney transplant

Answer 26

-Under 55 years old - Disease free - First look for ABO match - Then look at HLA genes -- certain A, B, DR genes

Question 27

heart transplant

Answer 27

-No HLA typing -- don't have the time - Only do ABO typing - Look at how ill is the person and geographically how close

Question 28

liver transplants

Answer 28

-live donors-- liver can regenerate itself -look for ABO comptabile -don't really need to HLA match (low incidence)

Question 29

is matching done for corneal transplants

Answer 29

no, avascular site-- not seen by immune system

Question 30

graft vs. host disease is seen most often

Answer 30

stem cell, lung, liver, bowel transplants

Question 31

how does graft vs. host disease work

Answer 31

-Transferred tissue recognize some antigen of the host as foreign -passenger t cells come with transplant -donor cells get activated and RXN -damage occurs

Question 32

most common transplant issue

Answer 32

host vs. graft

Question 33

why is immunosuppression done

Answer 33

needed to downregulate immune system -increased life of transplanted tissue -on these drugs for life

Question 34

immunosuppressant drugs

Answer 34

cyclosporine and tacrolimus

Question 35

cyclosporine

Answer 35

1st suppressant on the market -nephro toxic

Question 36

corticosteroids help

Answer 36

keep inflammation down

Question 37

monoclonal antibodies target

Answer 37

donor's t cells, kill them before they can do damage to the recipient

Question 38

what do monoclonal antibodies block

Answer 38

IL-2 receptors CD25 receptor sites

Question 39

monoclonal Abs against t cells drug

Answer 39

Basiliximab