Immunology 3: Transplantation Flashcards
Recall 3 organs that mat be transplanted for the purpose of saving life
Liver
Heart
Small bowel
Give an example of a life-enhancing organ transplant
Kidneys
What is an autograft?
Transplant from the same individual
Give one potential use for stem cells in organ transplantation
Stem cells can be stimulated to differentiate into a human nephron
What is a transplant between genetically-identical individuals called?
Isografts
What is an allograft?
Transplantation betwen different organs of the same species
Recall examples of free cells that may be transplanted?
Bone marrow
Pancreatic islets
Recall 3 examples of non-solid-organ transplantation
Blood
Tendons
Bone
What are the 2 classes of deceased organ donor?
After brain death
After cardiac death
When is brain death most likely to occur?
When someone suffers a brain event (eg stroke) that causes death in hospital, and doctors keep their heart beating and their lungs ventilated mechanically
Summarise the process of organ transplantation ABD
Heartbeat and ventilation maintained mechanically
Brainstem function checked to be nil
Organs extracted and put in cool ischaemic environment
What is the main advantage of organ donation ABD over ACD?
No ischaemic damage
Which organs are most suitable for donation ACD?
Kidneys
Recall the exclusion criteria for transplantation of an organ?
Viral infection
Malignancy
Drug abuse
Disease
What is a xenograft?
Transplant between individuals of a different species
Give an example of where xenograft is used
Porcine/ bovine heart valves
What is a composite graft? Give an example
Many tissues
eg face
What elements of equity are considered to decide who receives a transplant organ?
Time on waiting list
Imminence of death
What elements of efficiency are considered to decide who receives a transplant organ?
Best use of organ in terms of survival and graft survival
Which organisation is responsible for weighing up equity and efficacy of a transplant?
NHSBT (NHS Blood and Transplant)
Homozygosity between donor and recipient is important for which genes?
HLA-B/ HLA-DR
How is HLA mismatch noted?
As ratio: number of differences between HLA-A/B/DR
Eg MM 1:2:0
Recall the sequence of events leading to organ rejection when the wrong blood group is transplanted
Complement activation Phagocytes recruited Endothelium disrupted Platelets aggregate Thrombosis
How are organ-rejections classified?
Hyperacute: already sensitised
Acute: rapid de novo antibody synthesis
Chronic: slow reaction
