Flashcards in Transplantation Deck (24)
isograft? allograft? xenograft?
iso: identical twin
allograft: same species
xenograft: different species
ABO just in blood?
nope other systems as well, so try to match for transplant as well
1st of 2nd graft more tolerated?
which immune cell is responsible for rejection?
T-cells recognize what?
MHC I : universally expressed (CD8)
MHC II : APC inducible (CD4)
MHC genes are static?
Nope. highly polymorphic
HLA matching of how many usually?
Renal vs. Lung transplant which one has more HLA mismatches?
Lung because of time and shorter waiting list
3 types of rejection are?
antibody mediated: immediate
acute: days-weeks: T-cells
Chronic: months-years: Ab? immune complexes? viruses?
what helps to determine what preformed antibodies you have?
what happens if you get early episodes of acute rejection?
more problem with chronic rejection in future
2 non-immunological causes of chronic rejection?
viruses, ischaemia-reperfusion injury
what happens histologically in chronic rejection?
scarring/fibrosis around tubules etc.
chronic allograft rejection what can happen in:
scarring of bile ducts
bronchiolitis obliterans syndrome
hyperacute rejection mediated by?
antibodies and complement
3 ways to prevent rejection?
oldes immunosuppressive drug?
what drug is good at taking out recently activated T-cells?
cyclosporin and tacrolimus inhibits what?
what do calcineurin inhibitors leave you vulnerable to?
steroids for anti-rejection for what?
decrease lymphocytes and reaction to antigens but more risk of infection
what does azathioprine do?
non-specifically inhibits DNA and RNA synthesis, blocks IL2 prod
do we just use one drug for immunosuppression ? why?
use cocktail, so what you can use lower doses of the individual drugs and minimize side effects