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Micro- Transplants Flashcards

1
Q

What is the act of transferring cells, organs, or tissues from one person to another?

A

TRANSPLANTATION

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2
Q

What thwarts a successful transplant regardless of how skilled the surgeon is?

A

IMMUNOLOGIC ATTACK

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3
Q

True or False: Transplants that occur together do better than ones that occur alone

A

TRUE

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4
Q

AUTOGRAPH?

A

Self-tissue- Think burn patients

-Includes skin, bone, cartilage, and BM

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5
Q

ISOGRAPH/SYNGENEIC

A

Graft from a twin or clone

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6
Q

ALLOGRAFT

A

From someone of the same species

MOST COMMON

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7
Q

XENOGRAFT

A

From different species, like a pig heart valbe

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8
Q

Histoincompatible?

A

Antigenically different, rejection

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9
Q

Histocompatible?

A

Antigenically similar, no rejection

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10
Q

What tissue antigen is a primary player in graft rejection/acceptance?

A

MHC

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11
Q

What produces a less vigorous response, but also plays a role in graft rejection?

A

Minor histocompatibility antigens

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12
Q

What 2 things are responsible for most intense graft rejections?

A

ABO/MHC

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13
Q

What tests both donor and recipient tissue for blood type and MHC haplotypes?

A

Tissue typing

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14
Q

What is used to screen potential donors and is focused on class I MHC?

A

Microtoxicity test

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15
Q

What is used to determine degree of mismatch between donor and recipient and is focused on class II MHC?

A

Mixed lymphocyte reaction test

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16
Q

What happens if you tranfuse or put it an organ with mismatched blood

A

Antibodies immediately attack and lyse RBC via complement

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17
Q

What type of HS reaction is a bad transplant?

A

TYPE II HS REACTION

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18
Q

How many classes MHC?

A

3 - I, II, III

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19
Q

What do MHC do?

A

Recognize and bind antigenic peptides and present to T-cells

-SELF V. NON-SELF RECOGNITION

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20
Q

Class I MHC genes?

A

HLA- A B C

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21
Q

Class II MHC genes?

A

HLA- DP, DQ, DR

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22
Q

Class III MHC genes?

A

Cā€™, C2, C4, B
TNF alpha and beta

Think of III as dealing with complement and TNFs- that is good enough to know per first aid

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23
Q

What is it called when host Th cells become activated via interacting with donor APC that express ligand-MHC complex and provide a co-stimulatory signal?

A

Sensitization

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24
Q

What does sensitization involve?

A

Recognition of foreign MHC by recipient T cells

-Your body realizes something foreign is in it

25
What do most immunosupressant drugs inhibit that blocks T-cell proliferation?
IL-2
26
What stage involves destruction of the graft by cell mediated response?
EFFECTOR
27
What is most often the effector mechanism?
CMI with delayed type hypersensitivity and cytotoxic T-lymphocte response -Less often antibodies and ADCC
28
What is the hallmark of graft rejection?
Influx of T cells and macrophages
29
In English, what is the effector stage?
The actual destruction of the tissue (graft)
30
When does a hyperacute graft rejection occur?
24 hours- happens so fast tissue is rejected before it ever vascularizes
31
What causes a hyperacute graft rejection?
Pre-existing host antibodies specific for the antigens of the graft
32
What type of HS is hyperacute graft rejection?
TYPE II HS
33
What is activated in a hyperacute rejection that causes massive blood clots that prevent revascularization?
Complement--> Intense infiltration of PMNs into grafted tissue
34
Who is pre-disposed to a hyperacute graft rejection?
1. Repeated blood transfusions 2. Repeat pregnancies 3. Already have a graft
35
What prevents against hyperacute graft rejection?
ABO blood typing and HLA typing
36
What follows the kinetics of a CMI with average time till rejection of 10 days?
Acute
37
What happens in an acute graft rejection?
There is massive infiltration of macrophages and lymphocytes at the site of tissue destruction and is a result of primary Th cell activation and proliferation
38
What type of rejection follows the kinetics of secondary immune response?
Accelerated
39
What happens in an accelerated rejection?
There is reactivation of memory Th cells (occurs in days)
40
Who is likely to have an accelerated rejection?
Someone with more than 1 transplant
41
WHen does chronic graft rejection happen?
Months to years
42
What type of immunity is involved in chronic graft rejection?
Humoral and CMI
43
What can provoke chronic graft rejection?
Viral infection
44
What is used to increase short-term survival with grafts?
immunosuppresive therapy (usually for life)
45
What is one big issue with immunsuppressive therapy?
HIGH SUSCEPTIBILITY TO INFECTIONS
46
What is the most common cause of death post-transplant (50% within 6 months)?
Infection (usually opportunistic)
47
What do most transplant patients get leading to intersitial pneumonia and death?
CMV
48
Name 10 organs that have been successfully transplanted?
1. Cornea 2. Lung 3. Heart 4. Liver 5. Bone Marrow 6. Skin 7. Blood 8. Pancreas 9. Kidney 10. Intestine
49
What type of transplant is from an immunologically privileged site where HLA typing isn't necessary?
Cornea
50
Which type of transplant requires no HLA typing and why?
Liver- Not much HLA I on hepatocytes and virtually no HLA II- Based on ABO
51
What type of transplant is seen in burn victims?
Skin
52
What can be used as a biological dressing?
Frozen skin deposits
53
What is the most commonly transplanted solid organ?
Kidney
54
What is the only immune competent tissue that is transplanted and what can it cause?
BM (stem cell)... can cause GVHD
55
What is done normally to donor BM to get rid of mature cells because they will express the wrong MHC and start attacking the host
Irradiation
56
What organs does GVHD affect?
Skin, liver, lungs, intestine
57
What symptoms for GVHD?
1. Bright red rash: Palms/soles 2. Starts on face/neck and moves to trunk/lumbs 3. Profuse watery diarrhea 4. Liver function tests are abnormal 5. Lungs and BM become sites of inflammation
58
What is given for treatment of GVHD?
1. Corticosteroids and immunosuppressive drugs 2. Anti-CD3 and Anti-CD2 3. Anti-thymocyte serum

HemOnc (8 decks)

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