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Flashcards in Transplantation Deck (11):
1

chronic transplant rejection - mechanism

CD4 T cells respond to recipient APCs presentinf donor peptides, including allogenic MCR --> cytokines --> cellular and homural compoments (type II and IV hypersensitivity reactions)

2

chronic transplant rejection - results in / onset

cytokines --> proliferation of vascular SMCs, paremchymal atrophy, Interstitial fibrosis
DOMINATED BY ARTERIOSCLEROSIS
onset: month years

3

chronic transplant rejection - example of organs and results

1. lung --> bronchiolitis obliterans
2. Heart --> accelerated atherosclerosis
3. Kidney --> chronic graft nephropathy
4. Liver --> vanishing bile duct syndrome

4

Bronchiolitis obliterans?

bronchioles are compressed and narrowed by fibrosis (scar tissue) and/or inflammation --> life-threatening form of non-reversible

5

Graft-versus-host-disease - Mechanism / onset

grafted immunocompompetent T cells proliferate in the immunocompromised host and reject host cells with "foreign" proteins --> severe organ dysfunction (type IV hypersensitivity reaction)
onset: varies

6

Graft-versus-host-disease - requirements to occur

1. the graft must contain immunocommpoment T cells
2. the host must be immunocompromised
3. the recipient must express antigens (eg. MHC or other minor proteins) foreign to the donor

7

Graft-versus-host-disease - clinical manifestation

1. maculopapular rash
2. jaundice
3. diarrhea
4. hepatsplenomegaly

8

Graft-versus-host-disease - in transplantation of which organs

organs rich in lymphocytes:
--> esp a. bone marrow b. liver

9

Graft-versus-host-disease - potentially beneficial for

bone marrow transplant form leukemia (graft-vs-tumor effect

10

Graft versus tumor effect - definition

Donor T-cells eliminate malignant residual host T-cells (graft versus leukemia) or eliminates diverse kinds of tumors.

11

transplant rejection - types, onset (time) and hypersensitvity reaction

1. hyperacute --> minutes --> type 2
2. acute --> weeks to months --> type II (humoral) or IV (cellular)
3. chronic --> months to years --> both IV and IV (humoral and cellular)
4. graft-vs-host disease --> varies --> type IV