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Host And Defense Exam 4 > German - Tolerance And Transplants > Flashcards

German - Tolerance And Transplants Flashcards

1
Q

3 problems with transplantations?

A

Transplant must perform its fxs

Transplant and recipient health must be maintained

Recipient immune system must not reject the transplant

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2
Q

What are 2 transplantation types?

A

Solid organ

Blood

  • Bone marrow/hematopoietic stem cell
  • Transfusion

Demands exceeds supply, short term survival is good, LT attrition unchanged, not a permanent solution

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3
Q

What is an autologous transplant?

A

Donor and recipient are the same individual

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4
Q

What is a syngeneic transplant?

A

Donor and recipient are genetically identical

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5
Q

What is an allogeneic transplant?

A

Donor and recipient are genetically different but of the same species

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6
Q

What is an xenogeneic transplant?

A

Donor and recipient are of different species

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7
Q

T/F - Organ rejection limits allogeneic transplant survival.

A

TRUE

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8
Q

What are the three types of organ rejection?

A

Hyperacute

Acute

Chronic

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9
Q

What type of organ rejection is this?

  • Type II hypersensitivity
  • Minutes to hours
  • Blood type alloantibodies
A

Hyperacute

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10
Q

What type of organ rejection is this?

  • Type IV hypersensitivity
  • CD4 and CD8 T cells
  • HLA mismatches
A

Acute

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11
Q

What type of organ rejection is this?

  • Type III hypersensitivity
  • Chronic transplant inflammation
A

Chronic

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12
Q

T/F - Most transplants are allogeneic.

A

TRUE

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13
Q

What is the biggest predictor of transplant success?

A

Histocompatibility

  • Blood type
  • HLA major and minor genes

*Donor matching and immunosuppressants improve survival rates

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14
Q

What is the most common transplantation?

A

Blood transfusions

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15
Q

T/F - Erythrocytes do not express MHC I or II.

-So, no HLA matching

A

TRUE

  • Blood type and rhesus D antigens matched
  • Leukocytes removed from blood fractions
  • Leukocyte transfusions rarely performed
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16
Q

What are the 3 parts of blood commonly transfused?

A

Erythrocytes

Plasma - Water, protein (albumin and Ig), orgos, inorgos

Platelets - Clotting factors

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17
Q

What determines blood type and transfusion success?

A

ABO antigens

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18
Q

What is the universal donor and why?

A

O-

O has no oligosaccharides, but both antibodies in plasma, and the Rh- factor means the Rhesus factor is NOT present

19
Q

What is the universal recipient and why?

A

AB+

It has no antibodies and both oligosaccharides (A and B) and the Rhesus factor
-So, no matter the antibodies on the blood given, it will be fine, and if the transplanted blood is Rh+, then great, if Rh-, it doesn’t matter anyway

20
Q

What is encoded by HLA genes?

A

MHC I and MHC II - Major

NK cell stress ligands - Minor

21
Q

T/F - Some transplants can be done from live, healthy donors.

What are they?

A

TRUE

Kidney
Liver

22
Q

T/F - Transplant and recipient are in a state of inflammation.

A

TRUE

23
Q

Tell me the degree of match req’d for the following tissues:

Cornea?

Liver?

Kidney?

A

Cornea - No matching or immunosuppression

Liver - Only blood type needs to match

Kidney - HLA and blood type need to match

24
Q

____________ blood type antibodies cause hyperacute rejection.

A

Pre-existing

25
Q

Tell me about hyperacute rejection.

A

ABO and Rh factor incompatibility

Pre-existing anti-HLA class I antibodies

Type II hypersensitivity

Occurs w/in minutes

Irreversible organ loss

26
Q

Tell me the process of hyperacute rejection.

A

Healthy kidney grafted into pt w/ kidney failure and preexisting antibodies against donor blood group antigens

Antibodies against donor blood group antigens bind vascular endothelium graft, initiating an inflammatory response that occluded blood vessels

Graft become engorged and purple-colored b/c of hemorrhage

Graft failure

27
Q

Direct and indirect ________________ leads to graft rejection.

A

Allorecognition

  • Acute rejection
  • Direct allorecognition*
  • CD4/CD8 mediated
  • Type IV
  • Chronic rejection
  • Indirect allorecognition*
  • Antibody mediated
  • Type III

HLA class I and II antigens

Minor HLA antigens

28
Q

What causes acute rejection?

A

Direct allorecognition

29
Q

Tell me about allorecognition.

A

Kidney graft with dendritic cells

DCs migrate to the spleen and activate effector T cells

Effector T cells migrate to graft via blood

Graft destroyed by effector T cells

Transplant dendritic cells activate recipient T cells, direct MHC interaction, days to weeks, type IV hypersensitivity

30
Q

______ ______ activates T cells directly.

A

Allogeneic MHC

  • Direct recognition of foreign MHC
  • MHC structural difference
  • Peptide largely irrelevant
  • Activated transplant DCs express B7
  • CD8 and CD4 Th1 response
31
Q

What causes chronic rejection?

A

Antibodies against transplant MHC I

32
Q

Tell me about chronic rejection.

A

Type III hypersensitivity

Chronic inflammation

Progressive loss of blood and nutrient supply

Years

33
Q

Bone marrow/hematopoietic stem cell transplantations __________ the blood system.

A

Reset

Can treat blood diseases

Myeloid and lymphoid cancers

Autogeneic and allogeneic

Large donor pool

34
Q

What is one cause of GVHD (Graft vs host disease)?

A

Hematopoietic transplants

35
Q

What is GVHD?

A

Transplant adaptive immune cells target and kill recipient tissues

  • GI, liver, and skin problems most pronounced
  • Can be beneficial in fighting cancers
36
Q

Donor __ _______ cause acute GVHD.

A

T cells

37
Q

________ ____ ______ can kill recipient leukemia.

A

Alloreactive NK cells

38
Q

T/F - Donor and recipient MUST share some HLA class I and II haplotypes.

Why?

A

TRUE

If not, then antigen won’t be presented properly, and this results to no adaptive immune response

39
Q

___________ suppress NF-kappaB transcriptional activity?

A

Corticosteroids

40
Q

Tell me more about corticosteroids suppressing NF-kappaB transcriptional activity.

A

Immunosuppressants

PREDNISOLONE is the active compound

Increase in IkappaBalpha production blocks NF-kappaB fx

Broad activity

Non-specific

Many adverse side-effects

41
Q

Immunosuppression targets what?

A

T cell activation

3 signals

  • Activation
  • Survival
  • Proliferation
42
Q

_________ and ________ inhibit T cell activation.

A

Cyclosporin

Tacrolimus

43
Q

Belatacept and Anti-CD25 prevent what?

A

T cell survival and proliferation

Host And Defense Exam 4 (10 decks)

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