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Imunology > Lecture 27 (Transplantation and Transfusion) > Flashcards

Lecture 27 (Transplantation and Transfusion) Flashcards

1
Q

What is transplantation?

A

process of taking cells, tissues, or organs, called a graft, from one individual and placing them into a different individual

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2
Q

donor vs. recipient for transplants

A

donor: provides the graft (tissue, cells, etc.)
recipient: receives the graft (tissue, cells, etc.)

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3
Q

from one individual to the same individual

a) autologous transplant
b) syngeneic transplant
c) allogeneic transplant
d) xenogeneic transplant

A

a) autologous transplant

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4
Q

between two genetically identical individuals

a) autologous transplant
b) syngeneic transplant
c) allogeneic transplant
d) xenogeneic transplant

A

b) syngeneic transplant

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5
Q

between genetically different individuals of the same species

a) autologous transplant
b) syngeneic transplant
c) allogeneic transplant
d) xenogeneic transplant

A

c) allogeneic transplant

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6
Q

between individuals of different species

a) autologous transplant
b) syngeneic transplant
c) allogeneic transplant
d) xenogeneic transplant

A

d) xenogeneic transplant

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7
Q

why is MHC an important antigen in transplants

A

-highly polymorphic; unlikely to be similar between individuals

-polymorphic variants; can be recognized as foreign antigens when shared between individuals

-they are proteins themselves; highly antigenic

-potent stimulators of immune responses

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8
Q

transplant reactions are divided into what three different types of reactions?

A

-hyperacute reactions
-acute reactions
-chronic reactions

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9
Q

occur within minutes

a) hyperacute reaction
b) acute reaction
c) chronic reaction

A

a) hyperacute reaction

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10
Q

due to the presence of preformed antibodies within the recipient

a) hyperacute reaction
b) acute reaction
c) chronic reaction

A

a) hyperacute reaction

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11
Q

directed against graft vasculature

a) hyperacute reaction
b) acute reaction
c) chronic reaction

A

a) hyperacute reaction

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12
Q

how are hyperacute rejections/reactions avoided?

A

crossmatch procedure; blood typing

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13
Q

occur within days to weeks

a) hyperacute reaction
b) acute reaction
c) chronic reaction

A

b) acute reaction

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14
Q

mediated by T-cells and antibodies specific for alloantigens

a) hyperacute reaction
b) acute reaction
c) chronic reaction

A

b) acute reaction
c) chronic reaction

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15
Q

what is the most important alloantigen?

A

MHC II

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16
Q

occur over months to years

a) hyperacute reaction
b) acute reaction
c) chronic reaction

A

c) chronic reaction

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17
Q

directly kill graft cells

a) CD8+ CTLs
b) CD4+ cells

A

a) CD8+ CTLs

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18
Q

secrete cytokines and induce inflammation

a) CD8+ CTLs
b) CD4+ cells

A

b) CD4+ cells

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19
Q

t/f: RBC’s do not have MHC

A

true

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20
Q

RBC’s do not have MHC but rather have a variety of _____________ membrane proteins

A

glycosylated

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21
Q

t/f: animals may make antibodies to foreign blood group antigens even though they have never had a transfusion

A

true

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22
Q

what two species have natural antibodies to blood?

A

cats and humans

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23
Q

what are human blood types?

A

A, B, AB, O

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24
Q

what are feline blood types?

A

A, B, AB

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25
Q

87% of domestic cats are blood type ____

A

A

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26
Q

N-glycolyl-neuraminic acid

a) type A blood
b) type B blood

A

a) type A blood

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27
Q

N-acetyl-neuraminic acid

a) type A blood
b) type B blood

A

b) type B blood

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28
Q

t/f: there is no null-type to feline blood groups

A

true

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29
Q

75-90% of cats are A+; about 1/3 of type A cats have low level antibody against type ___

A

B

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30
Q

type B cats hav a high level of antibody against type _____

A

A
*crossmatching is critical

31
Q

t/f: type AB cats do not develop anti-A or anti-B

A

true

32
Q

what happens to cats with type B blood that receive type A blood?

A

normally immediate anaphylactic reaction

33
Q

what happens to cats with type A blood that receive type B blood?

A

-first time may be minor reaction
-second time anaphylactic reaction

34
Q

t/f: feline blood typing kits only determine major blood type

A

true

35
Q

how many blood group antigens do dogs have?

A

13

36
Q

how are dog blood types designated?

A

DEA 1.1, 1.2, 3-8

37
Q

t/f: only DEA 1 is of clinical significance in dogs

A

true

38
Q

which allele is the most antigenic in dogs?

A

DEA 1.1+

39
Q

what percentage of dogs are DEA 1.1+?

A

~32-67%

40
Q

if you have a DEA 1- dog who has had a prior transfusion with + blood, the dog becomes _____________

A

sensitized

41
Q

sensitization of - dam if bred to + male, may lead to ________ disease of newborns

A

hemolytic

42
Q

DEA ___ and ___ appear on ~98% of canine RBCs

A

4 and 6

43
Q

t/f: dogs generally have iso-antibodies to incompatible blood groups

A

false - do not have iso-antibodies until an initial exposure

44
Q

antibodies against incompatible blood can form in ___ to ___ days

A

5 to 7

45
Q

t/f: the half-life of compatible blood will be shorter than incompatible blood

A

false - the half-life of incompatible blood will be shorter than comparable blood

46
Q

what is the universal donor for canine blood typing?

A

DEA 1.1- is the best but also 1.2- and 7-

47
Q

horses have at least ___ blood groups

A

7

48
Q

what are equine blood types?

A

A, C, D, K, P, Q, U

49
Q

_____ and ______ are the most antigenic blood type variants in equine

A

Aa and Qa

50
Q

t/f: horses do not have preformed antibodies

A

true

51
Q

_________ ____________ is the most clinically relevant issue associated with equine blood types

A

Neonatal Isoerythrolysis

52
Q

Reasons for a blood transfusion

A

-anemia
-blood loss
-hemolysis
-massive hemorrhage
-etc.

53
Q

what does cross-matching blood types detect?

A

detects the presence of serum antibody to RBC antigens

54
Q

donor serum is mixed with recipient RBC

a) minor reaction
b) major reaction

A

a) minor reaction

55
Q

donor RBC is mixed with recipient serum

a) minor reaction
b) major reaction

A

b) major reaction

56
Q

for crossmatching when you do a major reaction (donor RBC is mixed with recipient serum), what would denote a positive cross reaction?

A

precipitation in the tubes

57
Q

what are the 4 reasons MHC proteins are such important antigens in transplants?

A
  1. Highly variable - unlikely to be similar in host & donor
  2. Recognizable as foreign by immune system
  3. Highly antigenic proteins (like most protein)
  4. Expressed in high numbers on cell surfaces
58
Q

which reactions to a transplant are targeted by current immunosuppressive therapies?

A

acute
*hyperacute reaction is avoided by cross matching blood type // chronic reaction is not subject to the therapy

59
Q

what is the important antigen for transfusions?

A

erythrocyte proteins (Glycosylated membrane proteins // “blood types” antigens)

60
Q

besides being born with them or being sensitized by a prior mismatched blood transfusion, why else might an animal have antibodies to a given blood type?

A

-Molecular mimicry (pathogen epitopes similar to their given blood antigens)

-Pregnancy related (HDN mechanism)

61
Q

what happens if you give a mismatched blood transfusion to a Type A cat?

A

-first time: may only have a minor reaction (only 1/3 of A cats have anti-B immunoglobulins), or could be the unlucky third
-second time: immediate anaphylactic reaction; lysis, hypotension, and shock

62
Q

what happens if you give a mismatched blood transfusion to a Type B cat?

A

first time you will have the immediate anaphylactic reaction because 100% of Type B cats are born with anti-A-immunoglobulins

63
Q

what is the most antigenic allele in regards to canine blood type?

A

DEA 1.1+

64
Q

what is the clinically significant locus in canine blood type genes?

A

DEA1 locus

65
Q

approximately what percent of dogs will be DEA1.1+

A

33-67%

66
Q

if a DEA1- dog receives a first transfusion, but the blood is mismatched what will happen?

A

the dog will become sensitized for future transfusion and using non-matched blood will no longer be a plausible option clinically
*relatively safe once since no preformed antibodies but worried about molecular mimicry or HDN issues

67
Q

the two most antigenic erythrocyte antigens for equine blood types are:

A

Aa and Qa

68
Q

in a Major Cross-Match you use the Recipients __________________ & the donor’s _______________. Mix them, incubate them, and check for precipitation if reactive

A

Recipient’s Serum; Donor’s RBCs

69
Q

dogs have blood volumes of ______% of their body weight

A

7-9%
*~70-90 ml/kg blood volume

70
Q

cats have blood volumes of _____% of their body weight

A

6-7%
*~60-70 ml/kg blood volume

71
Q

how do you calculate RBC volume?

A

blood volume x patient’s PCV%

72
Q

what needs to be monitored on a patient during transfusion?

A

-rectal temp
-pulse rate
-capillary refill time
-demeanor
-hives

73
Q

preformed antibodies can lead to ______________ reactions

A

hyperacute

74
Q

donor white blood cells and foreign proteins (cytokines) can lead to __________ reactions

A

acute

Imunology (10 decks)

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