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HemOnc > Micro- Transplants > Flashcards

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

C’, 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
Q

What do most immunosupressant drugs inhibit that blocks T-cell proliferation?

A

IL-2

26
Q

What stage involves destruction of the graft by cell mediated response?

A

EFFECTOR

27
Q

What is most often the effector mechanism?

A

CMI with delayed type hypersensitivity and cytotoxic T-lymphocte response

-Less often antibodies and ADCC

28
Q

What is the hallmark of graft rejection?

A

Influx of T cells and macrophages

29
Q

In English, what is the effector stage?

A

The actual destruction of the tissue (graft)

30
Q

When does a hyperacute graft rejection occur?

A

24 hours- happens so fast tissue is rejected before it ever vascularizes

31
Q

What causes a hyperacute graft rejection?

A

Pre-existing host antibodies specific for the antigens of the graft

32
Q

What type of HS is hyperacute graft rejection?

A

TYPE II HS

33
Q

What is activated in a hyperacute rejection that causes massive blood clots that prevent revascularization?

A

Complement–> Intense infiltration of PMNs into grafted tissue

34
Q

Who is pre-disposed to a hyperacute graft rejection?

A
  1. Repeated blood transfusions
  2. Repeat pregnancies
  3. Already have a graft
35
Q

What prevents against hyperacute graft rejection?

A

ABO blood typing and HLA typing

36
Q

What follows the kinetics of a CMI with average time till rejection of 10 days?

A

Acute

37
Q

What happens in an acute graft rejection?

A

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
Q

What type of rejection follows the kinetics of secondary immune response?

A

Accelerated

39
Q

What happens in an accelerated rejection?

A

There is reactivation of memory Th cells (occurs in days)

40
Q

Who is likely to have an accelerated rejection?

A

Someone with more than 1 transplant

41
Q

WHen does chronic graft rejection happen?

A

Months to years

42
Q

What type of immunity is involved in chronic graft rejection?

A

Humoral and CMI

43
Q

What can provoke chronic graft rejection?

A

Viral infection

44
Q

What is used to increase short-term survival with grafts?

A

immunosuppresive therapy (usually for life)

45
Q

What is one big issue with immunsuppressive therapy?

A

HIGH SUSCEPTIBILITY TO INFECTIONS

46
Q

What is the most common cause of death post-transplant (50% within 6 months)?

A

Infection (usually opportunistic)

47
Q

What do most transplant patients get leading to intersitial pneumonia and death?

A

CMV

48
Q

Name 10 organs that have been successfully transplanted?

A
  1. Cornea
  2. Lung
  3. Heart
  4. Liver
  5. Bone Marrow
  6. Skin
  7. Blood
  8. Pancreas
  9. Kidney
  10. Intestine
49
Q

What type of transplant is from an immunologically privileged site where HLA typing isn’t necessary?

A

Cornea

50
Q

Which type of transplant requires no HLA typing and why?

A

Liver- Not much HLA I on hepatocytes and virtually no HLA II- Based on ABO

51
Q

What type of transplant is seen in burn victims?

A

Skin

52
Q

What can be used as a biological dressing?

A

Frozen skin deposits

53
Q

What is the most commonly transplanted solid organ?

A

Kidney

54
Q

What is the only immune competent tissue that is transplanted and what can it cause?

A

BM (stem cell)… can cause GVHD

55
Q

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

A

Irradiation

56
Q

What organs does GVHD affect?

A

Skin, liver, lungs, intestine

57
Q

What symptoms for GVHD?

A
  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
Q

What is given for treatment of GVHD?

A
  1. Corticosteroids and immunosuppressive drugs
  2. Anti-CD3 and Anti-CD2
  3. Anti-thymocyte serum

HemOnc (8 decks)

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