#OrganTransplant

Question 1

What are the three tests that they do before a transplant?

Answer 1

> ABO blood type
HLA type
pre-existing anti-HLA antibodies

Question 2

How could you get pre-existing anti-HLA antibodies?

Answer 2

any type of exposure to foreign tissues:
> pregnancy
> blood transfusion
> other organ graft

Question 3

What type of hypersensitivity happens if you get an ABO/Rh reaction from a transplant?

Answer 3

#type II
> complement-mediated RBC LYSIS  or PHAGOCYTOSIS

Question 4

which type of cell has NO MHC molecules

Answer 4

shout out to #RBCs

ps. I decided to make this deck twitter themed

Question 5

if you accidentally give someone the wrong blood type, how will you know?

Answer 5

you'll see...
> fever #happens_a_lot
> chest pain
> hypotension
> disseminated intravascular coagulation (if severe)

Question 6

What are the two types of reactions after a transplant?

Which part attacks?

Answer 6

> transplant rejection: RECIPIENT T cells ATTACKS ORGAN

> graft vs. host: DONOR’S T cells ATTACK RECIPIENT’S ORGANS

Question 7

Acute rejection:
> time frame?
> cells?
> what is the cause?
> similar hypersensitivity rxn?

Answer 7

acute
> a few weeks
> Th1 (CD4+)   or   CD8
> HLAs don't match
> similar to type 4 (delayed type hypersensitivity)

Question 8

Acute rejection:

What are the three main events of the mechanism

Answer 8

> state of cytotoxicity (IL-2) to apoptose cells
delayed-type hypersensitivity (IFN-gamma, macrophages, TNF-alpha)
promote leukocyte migration (selectins, integrins, ICAM)

Question 9

what is a Mixed lymphocyte reaction?

what does it tell us?

Answer 9

#bloodbrothers
mix BLOOD cells of DONOR  and RECIPIENT to test HLA
lots of T cell proliferation = lots of mismatch
lots of cytotoxicity = lots of mismatch

Question 10

chronic rejection:
> time frame?
> we don’t know the mechanism, but what happens?

Answer 10

chronic
> months to years
> blood vessel walls THICKEN and it leads to ISCHEMIA

Question 11

What are the MINOR antigen blood groups?

Answer 11

> Rhesus : C, D, E

> Kell, Duffy, and MN exist, but they aren’t as significant

Question 12

there are 4 stages of graft vs host. what features do you use to decide the stage?

Answer 12

skin: how big is the rash?
Liver: how much serum bilirubin?
GI tract: how much diarrhea

Question 13

lets memorize rules for grading GVH! what is the rule for skin?

Answer 13

take away half of the rash
4 = 100% body rash + blisters and/or peeling 
3 = 100% body rash
2 = < 50% body rash
1 = < 25% body rash

Question 14

lets memorize rules for grading GVH! what is the rule for liver stuff?

Answer 14

start at 15 and take away (about) half of the bilirubin
4 = 15 mg/dL
3 = 6-15 mg/dL
2 = 3-6 mg/dL
1 = 2-3 mg/dL

Question 15

lets memorize rules for grading GVH! what is the rule for GI stuff?

Answer 15

start at #terrribbleeesss ( 1.5 L of diarrhea ) subract .5L
4 = terribbleessss (he just says cramping and maybe obstruction)
3 = 1.5 L diarrhea per day
2 = 1.0 L diarrhea per day
1 = 0.5 L diarrhea per day

Question 16

Fun fact via Dr. Kreisle: why do pig valves (for hearts) and cadaver ligaments (for ACLs) not give you GVH

Answer 16

apparently, connective tissue doesn’t have HLAs

> its just like putting in silicone #boobjob

Question 17

I think my uterus is rejecting me, what meds should I take? #help

Answer 17

immunosuppressive drugs
> corticosteriods
> cytotoxic drugs (chemo) to kill lymphocytes
> microbial immunosuppressive products
> immunosuppressive antibodies
.... otherwise just take some ibuprofen