Lecture 16: Transplants Flashcards
____: graft or transplant from one anatomical location to another on same person (e.g skin graft on burn patient)
A. Autograft
B. Allograft
C. Isograft
D. Xenograft
A. Autograft
In which case are donor and recipient histocompatible?
A. Autograft
B. Allograft
C. Isograft
D. Xenograft
C. Isograft
Isograft: graft or transplant from one person who is syngeneic to the donor (identical twins)
____: graft or transplant from one person that is genetically dissimilar, but of same species
A. Autograft
B. Allograft
C. Isograft
D. Xenograft
B. Allograft
____: a graft between donor and recipient from different species
Xenograft
_____: the first graft from a particular histo-incompatible (allograft or xenograft) donor leads to rejection after about 2 weeks
_____: the second graft from same donor will be completely rejected within a week
First-Set Rejection
Second-Set Rejection
True or False: Histological examination of failed transplants reveal lymphocytic and monocytic infiltrates
True
True or False: Athymic animals and humans do not reject allografts or xenografts
True
What are the three categories of Allograft rejection?
1) Hyperacute
2) Acute
3) Chronic
How can one slow process of graft rejection?
Suppress immune response (cell mediated immunity)
Hyperacute rejection occurs within a ____ of transplant, while acute rejection occurs within a few ___ and chronic occurs within ____or years
hours; days; months-years
There is no therapy for which allograft rejection?
Hyperacute
Is cell mediated immunity involved in hyperacute allograft rejections?
No
Which allograft rejection is caused by pre-formed antibodies to incompatible MHC molecules and activation of complement?
A. Hyperacute
B. Acute
C. Chronic
A. Hyperacute
A patient is pregnant and has recently had a blood transfusion. However, she is now experiencing a allograft rejection of which sort?
A. Hyperacute
B. Acute
C. Chronic
A. Hyperacute
True or False: Loss of organ function is seen in Chronic and Acute Allograft Rejections
True
If a patient is having a allograft rejection and has not been previously sensitized to the transplant antigen, what type of rejection is it most likely to be?
A. Hyperacute
B. Acute
C. Chronic
B. Acute
- note: this is a type of second set graft rejection
What is the primary means of acute allograft rejection?
T cell mediated immunity
- also incomplete or mismatch in HLA types between donor and recipient
How can acute rejections be treated or prevented?
Immunosuppressive drugs (antibodies against T lymphocytes, corticosteroids)
Acute rejection is histologically characterized by infiltration of ___ and ___
macrophages; lymphocytes
True or False: destruction of cells by cytotoxic T cells, phagocytosis, and presentation of transplanted antigens to helper T cell may occur in hyperacute allograft rejections
False - will occur in ACUTE allograft rejections!
Fever and leukocytosis are characteristic of which rejection?
A. Hyperacute
B. Acute
C. Chronic
A. Hyperacute
Which type of allograft rejection is caused by activation of CD4+ cells?
A. Hyperacute
B. Acute
C. Chronic
C. Chronic
Macrophage activation, cytotoxic T cell activation, antibody and complement (humoral), as well as AFCC is seen in which allograft rejection?
A. Hyperacute
B. Acute
C. Chronic
C. Chronic
Lymphoid proliferation, as well as formation of lymphoid follicles and fibrosis are seen in which type of allograft rejection?
A. Hyperacute
B. Acute
C. Chronic
C. Chronic
Why are immunosuppresive therapies useless in chronic rejection?
Damage has already taken place
How can you prevent Graft vs. Host Reactions?
Transplanted lymphocytes must be: IMMUNOCOMPETENT
Recipient must be: IMMUNOCOMPROMISED
E.g - bone marrow transplants
Hepato-splenomegaly, lymphadenopathy, diarrhea, anemia, and weight loss are symptoms of ______
GVH reaction
True or False: Transplantation of lymphocytes or their precursors from a donor to a genetically dissimilar recipient can result in the donor lymphocytes mounting an immune response against recipient’s tissues
True
___ of genes is of prime immunological importance in graft acceptance or rejection. The products of this complex of genes are known as HLA
MHC
Where is the MHC located?
Chromosome 6
MHC Class 1 genes are: ______
MHC Class 2 genes are: ____
MHC-A, MHC-B, MHC-C
MHC-DP, DQ, DR
___ alleles makes up the haplotype
six
- two haplotypes, one inherited from each parent, constitutes the genotype
The total number of HLA alleles expressed is __
12 (6 loci * 2 haplotypes)
True or False: HLA molecules are even more polymorphic than originally believed
True
Which molecules initiated graft rejection WITHOUT a requisite for processed peptide?
A. APC
B. HLA Class II
C. HLA Class I
B. HLA Class II
What is the key initiating event in ACUTE allograft rejection?
Direct activation of recipient’s CD4+ T cells by non-self HLA Class II molecules expressed on grafted tissue
Which molecules are the most potent transplantation antigens?
HLA Class II
Good parity between donor and recipient at the ____ locus is associated with longest graft survival
A. HLA-DQ
B. HLA-DR
C. HLA-DP
B. HLA-DR
Activation of CD4+ T cells via recognition of foreign HLA Class ___ occurs
HLA Class II
Recipients CD8+ T cells may also be directly activated by non-self ____, but require assistance of CD4+ T cells (via: IL-2) to become fully activated
HLA Class I
Which cytokines are most important in allograft rejection?
A. Th-1 in origin
B. IL-2
C. Th-2 in origin
A. Th-1 in origin
Graft rejections reflect a type __ immune response
A. Type 1
B. Type 2
C. Type 3
D. Type 4
A. Type 1
True or False: TNF-B is cytotoxic to graft cells
True
IFN-gamma, IFN-a/b, as well as TNF-a/B increase expression of HLA Class __ expression
HLA Class I
____ for accumulation and activation of macrophages and increased HLA Class II expression
IFN-gamma
___ is used to genotype HLA molecules
PCR
____: inhibit lymphocyte gene expression, downregulated adhesion receptors, inhibit phagocytosis, and HLA molecule expression
A. Anti-metabolites
B. Blocking Agents
C. FK 506
D. Corticosteroids
D. Corticosteroids
___: administration of mab therapy against CD3 (to block T cell activation) and against IL-23
Blocking agents
___: purine antagonists, DNA alkylating agents
A. Anti-metabolites
B. Blocking Agents
C. FK 506
D. Corticosteroids
A. Anti-metabolites