Chapter 13: Transplantation

Question 1

Autologous grafts? Also other name for this type of graft? Also and example?

Answer 1

autografts

those where tissue moved from one location to another in same individual (skin grafting in burns for example)

Question 2

Isografts? (also other name)

Answer 2

syngeneic grafts

those transplanted between gentically identical individuals (monozygotic twins)

Question 3

Allogeneic grafts.

Answer 3

those transplanted between genetically different members of the same species (kidney transplant)

Question 4

Xenogenic grafts.

Answer 4

those transplanted between members of different species (pig heart valve into human)

Question 5

Hyperacute graft rejection time frame?

Answer 5

minutes to hours

Question 6

What is the pathogenesis of hyperacute graft rejection?

Answer 6

• due to pre-formed ab due to transfusions, multi-parity, or previous organ transplants (type II cytotoxic hypersensitivity)
• ab bind to grafted tissue and activate complement and the clotting cascade resulting in thrombosis and ischemic necrosis

Question 7

Why are hyperacute rejections rare?

Answer 7

cross matching blood

Question 8

Acute graft rejection time-frame.

Answer 8

within days to weeks; timing and mechanism are similar to a primary immune response

Question 9

Acute graft rejections are induced by what?

Answer 9

allo-antigens (predominantly MHC) in the graft

Question 10

What lymphocytes play a role in acute graft rejection?

Answer 10

both CD4 and CD8 T cells play a role as well as antibodies (think normal immune response)

Question 11

How can you prevent acute graft rejections?

Answer 11

immunosuppressive therapy mainly

Question 12

What is the time frame involved with accelerated acute graft rejection?

Answer 12

within days; the timing and mechanism are similar to memory response

Question 13

What is the time-frame associated with chronic graft rejection?

Answer 13

occurs within months to years

Question 14

What cells primarily mediated the chronic graft rejection response?

Answer 14

• predominantly T-cell mediated

Question 15

Etiology of chronic graft rejection?

Answer 15

not well understood, possibly triggered by viral infections

Question 16

Describe treatment of chronic graft rejections?

Answer 16

difficult to treat and usually results in graft rejection

Question 17

CD52 is a marker found on what type of cells?

Answer 17

all lymphocytes

Question 18

Are monoclonal or polyclonal antibodies typically used in the treatment and prevention of graft rejection?

Answer 18

monoclonal therapies

Question 19

Monoclonal ab are used in the treatment and prevention of graft rejection along with what other classic therapies?

Answer 19

corticosteroids, cyclosporine A, rapamycin, etc.

Question 20

What is the target of the drug Daclizumab?

Answer 20

anti-IL-2 receptor antibody

Question 21

What is the target of the drug basiliximab?

Answer 21

anti-IL-2 receptor antibody

Question 22

What is the MOA of Daclizumab?

Answer 22

Blocks T cell proliferation via blocking the binding of IL-2

Question 23

MOA of Basiliximab?

Answer 23

opsonization of IL-2R bearing cells

Question 24

What is the target of the drug Muromonab?

Answer 24

anti-CD3

Question 25

What is the MOA of Muromonab?

Answer 25

blocks T cell activation by causing apoptosis

Question 26

What is the target of Belatacept?

Answer 26

CTLA-4- Ig

Question 27

MOA of Belatacept?

Answer 27

inhibits T cell activation by blocking the B7 co-stimulatory molecule binding to CD28

Question 28

Target of the drug Alemtuzumab?

Answer 28

anti-CD52

Question 29

MOA of Alemtuzumab?

Answer 29

Depletes pool of T cells by binding to them and causing complement mediated lysis