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MT6326 > 2S [LEC]: Transplantation > Flashcards

2S [LEC]: Transplantation Flashcards

1
Q

Transfer of cells, tissue, or organs from one part of the body or from one individual to another

A

Transplantation

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2
Q

The material to be transferred

A

Graft/ transplant

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3
Q

A lifesaving treatment for end-stage organ failure, cancers, autoimmune disorders, and other disease

A

Transplantation (grafting)

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4
Q

The most important antigen causing graft rejection

A

Human Leukocyte Antigen (HLA)

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5
Q

The MHC is located on what chromosome?

A

Chromosome 6

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6
Q

Most important Class I MHC

A

HLA-A and HLA-B

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7
Q

Proteins that is involved in gamma or delta T-cell responses

A

MHC Class I-related Chain A (MICA) Antigens

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8
Q

T/F: MICA antigens are expressed on all nucleated cells, T cells, and B cells

A

False (MICA is only expressed on nucleated cells, not on T or B cells)

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9
Q

Target for allograft immune response

A

MHC Class I-related Chain A (MICA) Antigens

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10
Q

Incompatibility leads to hyperacute graft rejection

A

ABO blood group antigens

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11
Q

Important barrier to solid organ transplants

A

ABO blood group antigens

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12
Q

Cell surface molecules that regulate NK cells

A

Killer Immunoglobulin-Like Receptors (KIRs)

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13
Q

MHC class associated with Killer Immunoglobulin-Like Receptors (KIRs)

A

MHC Class I

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14
Q

Humoral IR targeting self antigens that can lead to poor transplant outcomes

A

Self antigens

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15
Q

Transplantation that elicit no immune response and has the highest chance of graft survival

A

Autograft

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16
Q

Transplantation that occurs between two different but identical individuals, like in the case of identical twins

A

Isograft or Syngraft

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17
Q

Transplantation that occurs from one person to another, or of the same species

A

Allograft/ Homograft

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18
Q

Transplantation where the graft is coming from an animal or a different species

A

Xenograft

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19
Q

Graft transplanted from one place on the donor to the same place on the recipient

A

Orthotopic

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20
Q

Graft transplanted from one place on the donor to a different site on the recipient

A

Heterotopic

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21
Q

Graft property wherein the growth of the transplanted graft does not occur

A

Homostatic

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22
Q

Graft property wherein tissue growth after transplantation takes place

A

Homovital

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23
Q

Heart donation has a high chance of survival and is transplanted within how many hours?

A

4

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24
Q

Most immunogenic organ/tissue

A

Bone marrow

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25
Q

Least immunogenic organ/tissue

A

Cornea

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26
Q

Organs that have lower chances of being associated with GVHD

A

Kidney and Liver

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27
Q

Mechanism of graft rejection which causes thrombotic occlusion and preformed antibodies are involved, binding to donor blood vessels

A

Hyperacute rejection

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28
Q

Mechanism of graft rejection which causes damage of blood vessels of parenchyma

A

Acute cellular rejection

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29
Q

Primary cell involved in acute cellular rejection

A

Cytotoxic T cell

30
Q

The dominant lesion present in chronic rejection

A

Arterial occlusion

31
Q

Identify the type of graft rejection based on the mechanism:

Preformed antibodies to ABO, HLA, and certain endothelial antigens bind to donor vascular endothelium, activating complement and clotting factors

A

Hyperacute

32
Q

Identify the type of graft rejection based on the mechanism:

Leads to thrombus formation, ischemia, and necrosis of transplanted tissue

A

Hyperacute

33
Q

Identify the type of graft rejection based on the mechanism:

Same as for hyperacute rejection, but takes days instead of minutes to hours due to very low levels of donor-specific antibodies

A

Accelerated

34
Q

Identify the type of graft rejection based on the mechanism:

Cell-mediated response to foreign MHC-expressing cells, where CD4+ T cells produce cytokines and induce delayed type hypersenstivity

35
Q

Identify the type of graft rejection based on the mechanism:

Antibodies produced against HLA antigens bind to vessel walls, activate complement, and induce transmural necrosis and inflammation

36
Q

Identify the type of graft rejection based on the mechanism:

Delayed type hypersensitivity response, and possibly antibodies, to foreign HLA antigens on graft

37
Q

Identify the type of graft rejection based on the mechanism:

Graft arteriosclerosis and smooth muscle proliferation occur, resulting in fibrosis, scarring, and narrowing of vessel lumen

38
Q

Identify the type of graft rejection:

Occurs within 100 days or more

A

Graft-versus-host disease (GVHD)

39
Q

Identify the type of graft rejection based on the mechanism:

T cells in HSC, lung, or liver transplants react against foreign HLA proteins in the recipient’s cells, causing massive cytokine release, inflammation, and tissue destruction in various locations throughout the body

A

Graft-versus-host disease (GVHD)

40
Q

Oldest form of transplantation

A

Blood transfusion

41
Q

Allogeneic response seen in HSC transplants

42
Q

Type of GVHD that causes epithelial cell death in the skin, intestinal tract, and live, and may be fatal

A

Acute GVHD

43
Q

Type of GVHD that causes fibrosis and atrophy of one or more of these same target organs as well as the lungs and may also be fatal

A

Chronic GVHD

44
Q

The prevent and manage GVHD, what is done to patients in the early post transplant period?

A

Immunosuppressive therapy

45
Q

Which immune cells are primarily removed in immunosuppressive therapy?

46
Q

Ultimate goal of organ transplantation

A

Graft acceptance

47
Q

T/F: Solid organs for transplant can come from both living and deceased donors

48
Q

Organ transplant where a larger number of matched MHC alleles has a better graft survival

A

Kidney transplant

49
Q

Main stay in prevention and treatment of graft rejection

A

Immunosuppression

50
Q

Identify the immunosuppressant class:

Potent anti-inflammatory and immunosuppressive agent, but prolonged use increases the chances of developing diabetes mellitus and hypertension

A

Corticosteroids

51
Q

Identify the immunosuppressant class:

Blocks the production of cytokines and may act as chemoattractant

A

Corticosteroids

52
Q

Identify the immunosuppressant:

1st agent approved; interferes with lymphocyte maturation and kill proliferating cells

A

Azathioprine (antimetabolite)

53
Q

Identify the immunosuppressant:

Blocks signal transduction in T cells, leading to impaired synthesis of cytokines

A

Cyclosporine and Tacrolimus (Calcineurin inhibitors)

54
Q

Identify the immunosuppressant class:

Blocks the activation of NFAT transcription factor

A

Calcineurin inhibitors

55
Q

Identify the immunosuppressant:

Inhibits T-cell proliferation by binding to specific intracellular proteins

A

Rapamycin (Sirolimus) (Calcineurin inhibitors)

56
Q

Identify the immunosuppressant class:

Binds to cell surface molecules; used at the time of transplantation and for treatment of severe rejection episodes after transplantation

A

Monoclonal antibodies

57
Q

Identify the immunosuppressant:

Binds to CD25 (IL2 receptor)

A

Basiliximab (Monoclonal antibody)

58
Q

Identify the immunosuppressant:

Binds to CD52 receptor; for induction therapy during transplantation

A

Alemtuzumab (Monoclonal antibody)

59
Q

Identify the immunosuppressant class:

Depletes lymphocytes from circulation

A

Polyclonal antibodies

60
Q

Identify the immunosuppressant:

Antithymocyte Ab prepared from rabbits

A

Thymoglobulin (Polyclonal antibody)

61
Q

Identify the immunosuppressant:

Polyclonal antiserum prepared from immunized horses

A

ATGAM (Anti-thymocyte Globulin [Equine])

62
Q

Identify the immunosuppressant class:

Prevents the delivery of costimulatory signals required for activation of T cells, reducing acute graft rejection

A

Costimulatory blockade

63
Q

Identify the immunosuppressant:

Binds to B7 molecules on APCs and prevents them from interacting with T cell CD28

A

CTLA4Ig (Belatacept) (Costimulatory blockade)

64
Q

Phenotypic or genotypic identification of the HLA antigens or genes in a transplant candidate or donor

A

HLA typing

65
Q

Principle of HLA phenotyping

A

Complement-dependent cytotoxicity (CDC)

66
Q

PCR-based amplification of HLA genes followed by analysis of the amplified DNA to identify the specific HLA allele or allele group

A

HLA genotyping

67
Q

The gold standard for HLA genotyping

A

PCR-SBT (Polymerase Chain Reaction with Sequence-Based Typing)

68
Q

The only technique that directly detects the nucleotide sequence of an allele

A

PCR-SBT (Polymerase Chain Reaction with Sequence-Based Typing)

69
Q

Used as a predictive test for T-cell mediated rejection

A

Mixed lymphocyte reaction

70
Q

An HLA mismatch will have what result in the mixed lymphocyte reaction?

71
Q

This method checks the immunological incompatibility of the donor and recipient before transplantations using thymidine as an indicator or label

A

Mixed lymphocyte culture

MT6326 (24 decks)

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