Transplantation Flashcards
(26 cards)
what are the four types of transplantation?
allograft
autograft
isograft
xenograft
what are the two classes of histocompatibility?
class 1 and class 2
what class of MHC is on all nucleated cells?
class 1
what class of MHC is most important in rejection?
class 2
what HLA is present on class 1?
A, B, C
what HLA is present on class 2?
DR, DP, DQ
give an example of a privileged transplant?
corneal transplant
state some causes of rejection
ABO and HLA incompatible
failed immunosupression
infection triggers
is ABO or HLA used for chronic or acute rejection
ABO is acute rejection
HLA is chronic rejection
state some causes of pre formed immunity
blood transfusion
pregnancy
state the immediate rejection pathology
Innate immune system – complement activation and encourages neutrophils and NK cells and causes inflammation and thrombosis
how long after a transplant can acute rejection occur
6 months
what occurs in acute rejection?
T cell activation
APC cells present the antigens via MHC molecules
co-stimulation using CD4, 28 and 40
what occurs in chronic rejection
Cytokines and antibodies causes a chronic inflammation and causes the endothelium of the blood vessels thicken so must that the smooth muscle proliferates and reduces blood flow and causes ischaemia
what is the treatment for rejection
Corticosteroids
Anti-thymocyte globulin
Plasma exchange
Immunosuppression
what are some complications of rejection
Infection (opportunistic infection) • Commensal flora in the body become a problem in immunocompromised patients Neoplasia Drug side effects Surgical problems
state two ways of prevention of rejection
♣ ABO and HLA matching
♣ Prophylactic immunosuppression
what transplant is graft versus host disease common in
bone marrow transplant
what are two ways to prevent graft versus host disease?
donor/recipient matching
donor marrow T cell depletion
what is a side effect of anti-proliferative drugs?
diarrhoea
what are the three stages of rejection?
immediate
acute
chronic
what types of rejection is the most common?
chronic
describe what happens in chronic rejection?
• Cytokines and antibodies causes a chronic inflammation and causes the endothelium of the blood vessels thicken so must that the smooth muscle proliferates and reduces blood flow and causes ischaemia
state some complications of rejection?
infection
neoplasia
drug side effects
surgical problems
