Transplant Flashcards Preview

Kidneys > Transplant > Flashcards

Flashcards in Transplant Deck (28):
1

What is graft rejection?

Graft rejection is an example of where the immune response acts detrimentally to the transplant recipient

2

Xenograft?

Transfer of tissue between species

3

Isograft?

Identical twins

4

Autograft?

One part of the body to another

5

Allograft?

Same species, different person

6

What does syngeneic mean?

Identical twins

7

What happens to a second skin graft on the same individual?

It is rejected faster than the first

8

What are the cells responsible for rejection?

T-cells

9

What are the T cells reacting against?

MHC/HLA molecules

10

Chromasome for HLA?

6 (short arm)

11

Where is class 1 HLA expressed?

– Universally expressed
– Cytoplasm derived proteins
– Presents Ag to CD8+ T cells

12

Where is class II HLA expressed?

– APC, inducible on other cells
– Extracellular derived proteins
– Presents Ag to CD4+ T cells

13

What are other markers we look for in transplantation?

A1
A2
B27
B8
DR3
DR3

14

What determines who gets a kidney?

HLA matching
This does not occur for other organs (eg lung)

15

What are the three types of rejection?

Antibody mediated
Acute
Chronic

16

When can Antibody mediated rejection take place?

Can be any time (even months or years later)

17

What are the types of antibody responses in rejection?

Pre formed antibodies
- Blood group
- MHC
Previous
- Blood transfusion
- Pregnancy
- Transplant

18

What is acute allograft rejection?

Foreign material travels to the lymph nodes where it can activate a T cell mediated response

19

What is chronic allograft rejection?

Can be both immunological and non-immunological

20

What is common to all chronic allograft rejection?

Intimal loss → loss of tubules

21

How do we prevent allograft rejection?

• Matching ABO antigens (not just expressed on erythrocytes)
• Matching MHC alleles
• Immunosuppressive drugs

22

How do we knock out the immune system?

Knock out the T cell

23

What drug is used to knock out the immune system?

Cyclosporin - selectively knocks out recently activated T cells

Also use steriods and azathioprine

24

What is a problem with using cyclosporin?

No longer effective at fighting viruses

25

What is the action of steroids?

anti-inflammatory effects

26

Side effects of steroids?

Fluid retention
Hypertension
Susceptibility to infection

27

What are the steps in the creation of a bioartificial lung?

Take donor lung

Decellularize with detergent

Establish acellular vasculature, airways and alveoli

Seed scaffold with epithelial and endothelial cells

Perfuse and ventilate in bioreactor

28

Future clinical applications of bioartificial transplants?

Standard organ donor

Decellularize

Reconstitute with the recipient’s own (damaged) lung endothelial and epithelial cells

Transplant