Organ transplantion

Question 1

HLA typing

Answer 1

done on potential donors and recipients, depends on the type of organ, In kidney and bone marrow transplantation, HLA matching is very important, since these transplants are a high risk for graft rejection

Question 2

Panel of Reactive Antibodies (PRA)

Answer 2

indicates the recipient’s sensitivity to various HLA before receiving a transplant. calculated in percentages and a high PRA indicates that the person has a large number of cytotoxic antibodies and is highly sensitized, which means there is a poor chance of finding a cross match negative donor.

Question 3

Cross match ( serum from the recipient mixed with donor lymphocytes)

Answer 3

test for any preformed anti HLA antibodies to the potential donor organ. used as a screening test when multiple possible living donors are being considered or once a cadaver donor is selected.

Question 4

Positive cross match indicates

Answer 4

the recipient has cytotoxic antibodies to the donor and is an absolute contraindication to transplantation.

Question 5

Transplant Rejection

Answer 5

occurs as a normal immune response to foreign tissue.

Question 6

Transplant rejection prevention

Answer 6

using immunosuppression therapy, performing ABO, HLA matching, and ensuring that the cross match is negative.

Question 7

Hyper acute rejection

Answer 7

occurs minute to hours after transplantation because the blood vessels are rapidly destroyed. occurs because the person had preexisting antibodies against the transplanted tissue or organ. There is no treatment

Question 8

Acute rejection

Answer 8

most commonly manifests in the first 6 months after transplantation. often mediated by the recipients lymphocytes which have been activated against the donated tissue or organ. Usually reversible with additional immunosuppressive therapy, puts them at risk for infection.

Question 9

Chronic rejection

Answer 9

months to years occur for unknown reasons or from repeated episodes of acute rejection. Results in fibrosis and scarring, no definitive therapy

Question 10

Immunosuppressive therapy

Answer 10

used to prevent rejection of the transplanted organ, risk for infection

Question 11

Calcineurin inhibtors

Answer 11

foundation of most immunosuppression regimens, include tacrolimus and cuclosporine, don’t take it with grapefruit or juice, risk for nephrotoxicity

Question 12

Sirolimus

Answer 12

immunosuppressive agent approved for use in renal transplant recipients.

Question 13

Mycophenolate Mofetil

Answer 13

suppressive effects on both T and B lymphocytes, GI toxicities( nausea, vomiting , diarrhea) lower dose is a treatment. not give as IV bolus, when given IV must be reconstituted in D5 W and no other solution

Question 14

Monoclonal Antibodies

Answer 14

used for preventing and treating acute rejection episodes. a flu like syndrome occurs during the first few days of treatment because of cytokine release. fever rigors, headache, myalgias, and various GI disturbances. to reduce side effects Tylenol , Benadryl and IV methylprednisolone is given

Question 15

Polyclonal Antibody

Answer 15

Lymphocyte immune globulin is used as induction therapy or to treat acute rejection.

Question 16

What is induction therapy?

Answer 16

is to severely immunosuppress an individual immediately after transplantation to prevent early rejection.

Question 17

Graft verses- Host disease

Answer 17

occurs when an immune incompetent patient receives immune- competent cells. the graft rejects the host tissue

Question 18

Cytoxic drugs list

Answer 18

Azathioprine( Imuran), Mycophenolate mofetil( cellcept), Cyclophosphamide(Cytoxan), Sirolimus(Rapammune).
Risk for infection and bleeding