CHAPTER 16: Transplantation Immunology

Question 1

Which of the following responses is the type of allograft rejection associated with vascular and parenchymal injury with lymphocyte infiltrates?
a. Hyperacute rejection
b. Acute cellular rejection
c. Acute humoral rejection
d. Chronic rejection

Answer 1

b. Acute cellular rejection

Question 2

Antigen receptors on T lymphocytes bind HLA class II+ peptide complexes with the help of which accessory molecule?
a. CD2
b. CD3
c. CD4
d. CD8

Answer 2

c. CD4

Question 3

Patients who have received the following types of grafts are at risk for graft-versus-host disease (GVHD) except for recipients of
a. bone marrow transplants.
b. lung transplants.
c. liver transplants.
d. irradiated leukocytes.

Answer 3

d. irradiated leukocytes.

Question 4

Which of the following properties are not exhibited by HLA molecules?
a. They belong to the immunoglobulin superfamily.
b. They are heterodimeric.
c. They are integral cell membrane glycoproteins.
d. They are monomorphic.

Answer 4

d. They are monomorphic.

Question 5

Kidney allograft loss from intravascular thrombosis without cellular infiltration 5 days post-transplant may indicate which primary rejection mechanism?
a. Hyperacute rejection
b. Accelerated humoral rejection
c. Acute humoral rejection
d. Acute cellular rejection

Answer 5

b. Accelerated humoral rejection

Question 6

Which reagents would be used in a direct (forward) donor-recipient crossmatch test?
a. Donor serum and recipient lymphocytes + rabbit serum complement
b. Recipient serum and donor lymphocytes + rabbit serum complement
c. Donor stimulator cells + recipient responder cells + complete culture medium
d. Recipient stimulator cells + donor responder cells + complete culture medium

Answer 6

b. Recipient serum and donor lymphocytes + rabbit serum complement

Question 7

The indirect allorecognition pathway involves which one of the following mechanisms?
a. Processed peptides from polymorphic donor proteins restricted by recipient HLA class II molecules
b. Processed peptides from polymorphic recipient proteins restricted by donor HLA class I molecules
c. Intact polymorphic donor protein molecules recognized by recipient HLA class I molecules
d. Intact polymorphic donor protein molecules recognized by recipient HLA class II molecules

Answer 7

a. Processed peptides from polymorphic donor proteins restricted by recipient HLA class II molecules

Question 8

Which immunosuppressive agent selectively inhibits IL-2 receptor-mediated activation of T cells and causes clearance of activated T cells from the circulation?
a. Mycophenolate mofetil
b. Cyclosporine mofetil
c. Corticosteroids
d. Daclizumab

Answer 8

d. Daclizumab

Question 9

Phenotyping for HLA class II antigens requires B lymphocytes because
a. B lymphocytes express HLA class II antigens.
b. B lymphocytes do not express HLA class I antigens.
c. B lymphocytes are exquisitely sensitive to complement-mediated lysis.
d. B lymphocytes represent the majority of lymphocytes in the peripheral blood.

Answer 9

a. B lymphocytes express HLA class II antigens.

Question 10

A renal transplant candidate was crossmatched with a donor that was mismatched for only the HLA-B35 antigen. The candidate was known to have an anti-body specific for HLA-B35. Which of the following combinations of T- and B-cell flow cytometric crossmatch results would be expected?
a. T cell negative, B cell negative
b. T cell positive, B cell positive
c. T cell negative, B cell positive
d. T cell positive, B cell negative

Answer 10

b. T cell positive, B cell positive

Question 11

Which of the following HLA alleles differs from
A02:01:02 by a synonymous nucleotide substitution?
a. A01:01:01:01
b. A02:01:03
c. A02:02
d. A*02:03:01

Answer 11

b. A*02:01:03

Question 12

Which one of the following donors would be expected to elicit a positive mixed lymphocyte response in lymphocytes from a patient who has the HLA-DRB101:01, 01:03 alleles?
a. DRB101:01, 01:03
b. DRB101:01, 01:01
c. DRB101:03, 01:03
d. DRB1*01:01, 01:05

Answer 12

c. DRB1*01:03, 01:03

Question 13

Which of the following donors would be the most appropriate, based on ABO compatibility, for a renal transplant candidate with the ABO type = O?
a. O
b. A
c. B
d. AB

Answer 13

a. O

Question 14

Which of the following HLA antigens would be expected to elicit an HLA antibody response in a kidney transplant recipient with the following HLA type:

HLA-A01,03; B07,14; C01,04N; DRB116,07?

a. HLA-A*01

b. HLA-B*14

c. HLA-C*04

d. HLA-DRB1*16

Answer 14

c. HLA-C*04

Question 15

Suppose a 30-year-old man was found to be a suitable donor for a kidney transplant to his younger sister. This transplant would be an example of a(an)
a. autograft.
b. allograft.
c. isograft.
d. xenograft.

Answer 15

b. allograft.