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MCD Y2: Immunology > Immunology 3: Transplantation > Flashcards

Immunology 3: Transplantation Flashcards

1
Q

Recall 3 organs that mat be transplanted for the purpose of saving life

A

Liver
Heart
Small bowel

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2
Q

Give an example of a life-enhancing organ transplant

A

Kidneys

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3
Q

What is an autograft?

A

Transplant from the same individual

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4
Q

Give one potential use for stem cells in organ transplantation

A

Stem cells can be stimulated to differentiate into a human nephron

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5
Q

What is a transplant between genetically-identical individuals called?

A

Isografts

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6
Q

What is an allograft?

A

Transplantation betwen different organs of the same species

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7
Q

Recall examples of free cells that may be transplanted?

A

Bone marrow

Pancreatic islets

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8
Q

Recall 3 examples of non-solid-organ transplantation

A

Blood
Tendons
Bone

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9
Q

What are the 2 classes of deceased organ donor?

A

After brain death

After cardiac death

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10
Q

When is brain death most likely to occur?

A

When someone suffers a brain event (eg stroke) that causes death in hospital, and doctors keep their heart beating and their lungs ventilated mechanically

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11
Q

Summarise the process of organ transplantation ABD

A

Heartbeat and ventilation maintained mechanically
Brainstem function checked to be nil
Organs extracted and put in cool ischaemic environment

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12
Q

What is the main advantage of organ donation ABD over ACD?

A

No ischaemic damage

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13
Q

Which organs are most suitable for donation ACD?

A

Kidneys

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14
Q

Recall the exclusion criteria for transplantation of an organ?

A

Viral infection
Malignancy
Drug abuse
Disease

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15
Q

What is a xenograft?

A

Transplant between individuals of a different species

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16
Q

Give an example of where xenograft is used

A

Porcine/ bovine heart valves

17
Q

What is a composite graft? Give an example

A

Many tissues

eg face

18
Q

What elements of equity are considered to decide who receives a transplant organ?

A

Time on waiting list

Imminence of death

19
Q

What elements of efficiency are considered to decide who receives a transplant organ?

A

Best use of organ in terms of survival and graft survival

20
Q

Which organisation is responsible for weighing up equity and efficacy of a transplant?

A

NHSBT (NHS Blood and Transplant)

21
Q

Homozygosity between donor and recipient is important for which genes?

A

HLA-B/ HLA-DR

22
Q

How is HLA mismatch noted?

A

As ratio: number of differences between HLA-A/B/DR

Eg MM 1:2:0

23
Q

Recall the sequence of events leading to organ rejection when the wrong blood group is transplanted

A 
Complement activation
Phagocytes recruited
Endothelium disrupted
Platelets aggregate
Thrombosis
24
Q

How are organ-rejections classified?

A

Hyperacute: already sensitised
Acute: rapid de novo antibody synthesis
Chronic: slow reaction

25
Q

Which T cells are released first in a T cell-mediated rejection of an organ?

A

CD4+

26
Q

How do CD8+ T cells induce apoptosis?

A

Granzyme

Fas-L

27
Q

What sort of antibodies may be problematic in transplant?

A

Anti-graft HLA

Ant-graft blood antigen

28
Q

What is the main target site of anti-graft antibodies?

A

Endothelium

29
Q

Recall the liver-based evidence of transplant rejection

A 
Elevated creatinine
pain
fever
LFTs
fluid retention
30
Q

What is the main risk of being an organ donor?

A

Major perioperative morbidity

31
Q

What is the main perioperative risk factor for transplant recipients?

A

Immunosuppression

32
Q

What is the MOA of drugs that act to suppress the T cell response?

A

Block cytokines involved in T cell response

33
Q

Recall 3 ways of treating B cell-mediated rejection of a graft

A
  1. Plasma exchange (replenish Ig)
  2. Proetosome inhibitors (block Ab production)
  3. Block complement activation
34
Q

Recall 2 infections that prophylaxis is given for following transplant

A

CMV

BKV

35
Q

Why is EBV infection in transplant patients particularly dangerous?

A

Drives lymphoproliferative disorders

36
Q

Which malignancies does transplant increase risk of?

A

Lymphoproliferative

Skin

MCD Y2: Immunology (5 decks)

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