Transplant Immunology B6

Question 1

HS 1 antibody or cell mediated? what antibody?

Answer 1

antibody IgE

Question 2

HS 2 and HS 3 antibody or cell mediated? what antibody?

Answer 2

antibody IgG and IgM

Question 3

HS 4 antibody or cell mediated? what antibody?

Answer 3

cell mediated, T cell driven

Question 4

Act of transferring cells tissues or organs (GRAFT) from one individual (DONOR) to another (Recipient)

Answer 4

Transplant

Question 5

Self tissue transferred from one body site to another in the same individual

Answer 5

Autografts

Question 6

Tissue transferred between genetically identical individuals

Answer 6

Isograft

Question 7

Tissue transferred between genetically different members of the same species.

Answer 7

Allograft

Question 8

Tissue transferred between different species

Answer 8

Xenograft

Question 9

Host vs Graft disease

Answer 9

Transplanted tissue is rejected by host

Question 10

Graft vs host disease

Answer 10

Immunocompromised (IMPORTANT)

-Host is attacked by tranplanted T-cells

Question 11

Every nucleated cell has ____.

Answer 11

HLA is on short arm of Chromosome 6

Question 12

Not all HLA are equal in HLA rejection…. what are the 3?

Answer 12

HLA-A, HLA-B and

HLA-DR=MOST IMPORTANT

Question 13

HLA-A HLA-B are what MHC?

Answer 13

MHC I

Question 14

HLA-DR is what MHC?

Answer 14

MHC II

Question 15

_____________ are second most common transplanted tissue in US is what? what is number 1?

Answer 15

Cornea transplants (32,000 per year)
Blood is #1 (5,000,000 per year)

Question 16

Cornea does not express _________.

Answer 16

HLA/MHC

Question 17

What happens in a graft acceptance AutoGraft?

Answer 17

Chunk of tissue dropped into skin
Wait 7 days, vessels have reconnected and healing
2 weeks= total resolution, vascularization, lymphocytes and white blood cells don’t recognize anything foreign… Neutrophils come in and clean it up

Question 18

______ are critical in transplant rejection.

Answer 18

T-cells

Question 19

What happens in graft rejection?

Answer 19

Day 3-7 REvascularization
Day 7-10 Cellular infiltration
Day 10-14 Thrombosis and necrosis
Damaged vascularization and reject necrotic tissue

Question 20

Why are we worried on first graft?

Answer 20

If rejected on first graft, likely to not accept on second graft.

Question 21

_________ play central role in rejection, but cLassical cause of rejection is ________

Answer 21

Thymus (T-cells)

Lymphocytes

Question 22

Rats devoid of thymus accept _________

Answer 22

xenografts

Question 23

Long survival of _______ in children with thymic deficiency

Answer 23

allografts

Question 24

______ and _____ cells are involved in graft rejection.

Answer 24

CD4 and CD8

Question 25

If you block CD8 alone what happens? If you block CD4 alone what happens? If you block CD8 and CD4 what happens?

Answer 25

Graft rejected in ~15 days (Same as control, might think CD8 doesn't play role, but... hold on) Graft rejected in ~30 days (CD4 plays key role) Graft rejected in ~60 days (CD4 and CD8 are playing a role.

Question 26

When we are looking at tranplanting an organ we want to make sure what?

Answer 26

Make sure ABO compatible, (blood types compatible) | Dont want to transplant tissues that are ABO incompatible.

Question 27

These play a role in graft rejection: Antibody-mediated cytotoxicity Cell-mediate / Delayed type hypersensitivity

Answer 27

Type II hypersensitivity | Type IV

Question 28

Every immune reaction starts with _________.

Answer 28

sensitization

Question 29

Cell that recognizes MHC- II?

Answer 29

CD4 Traffic cop

Question 30

Cell that recognizes MHC I?

Answer 30

CD8

Question 31

During sensitization what happens?

Answer 31

donor and recipient APCs migrate from graft to stimulate activation of T lymphocytes

Question 32

In effector stage what happens?

Answer 32

Antibody mediated component, Type II antibody dependent cytotoxicity -complement activation and cell lysis

Question 33

Cytokines released by Th cells play central role in what?

Answer 33

IL 2, IFN gamma, TNF beta

Question 34

IL-2 does what?

Answer 34

promotes T cell proliferation (CTLs)

Question 35

TNF alpha and TNF beta are ________ to tissues and play role in inflammatory response

Answer 35

cytotoxic

Question 36

IFN gamma promotes _________ response, promotes influx of macrophages. Upregulates MHC I and II to make sure they are real (IMPORTANT)

Answer 36

Delayed type hypersensitivity (HS TYPE 4)

Question 37

Hyper acute reaction is an _____________ rejection. (IMPORTANT)

Answer 37

antibody-mediated (TYPE 2 HS)

Question 38

TNF B ________ foreign cells. (IMPORTANT)

Answer 38

Lyses

Question 39

An acute rejection is an __________ rejection. (IMPORTANT)

Answer 39

Cell-mediated (Type IV) | T-cell driven

Question 40

There are antibodies to MHC/HLA if they are preexisting they can have a __________ response.

Answer 40

Hyper acute (min to hours to days) Pre existing antibodies to HLA -This can happen because of previous blood transfusions (WBCs)

Question 41

Chronic rejection is a ___________ and _________ rejection. (IMPORTANT)

Answer 41

Antibody (TYPE 2 HS) and cell mediated (TYPE IV HS)

Question 42

Renal graft failure takes weeks up to 6 months...

Answer 42

Acute

Question 43

Renal graft failure takes >6 months

Answer 43

Chronic

Question 44

Mononuclear cells

Answer 44

CD4 cells

Question 45

Acute rejection happens within ______.

Answer 45

weeks

Question 46

Chronic develops _____ or ______ after transplantation.

Answer 46

months or years

Question 47

How do we test tissue typing?

Answer 47

Test for HLA through Microcytotoxicity test

Question 48

IF you have a blue circle the cell had what?

Answer 48

Cell had MHC antigen on it. Find the matched donor. Do they match ABO type?

Question 49

Which match is more important in survival of graft?

Answer 49

MHC-II

Question 50

HLA A and B are most important in which MHC class?

Answer 50

MHC-I

Question 51

HLA DR is most important in what MHC class?

Answer 51

MHC-II

Question 52

Compatibility is determined by mixing killed donor lymphocytes (MHC) with recipient lymphocytes. See if they activate when come into contact.

Answer 52

Mixed Lymph Response

Question 53

In MLR a low number means what and a high number means what?

Answer 53

Low number= patient is happy | High number= patient is not happy

Question 54

Whats the requirement for a cornea transplant?

Answer 54

nothing, no MHC