personalised medicine: transplantation

Question 1

What has made renal transplantation possible?

Answer 1

immunosuppresants as a long term therapy

Question 2

Why are immunosuppressants needed?

Answer 2

immune response to non self organ bc of HLA tissue type match.

Question 3

What are the two types of graft rejection?

Answer 3

1)chronic which is gradual and the time of onset/rate of progression varies but ultimately the graft is rejected 2)Acute which is most frequently observed within weeks and is reversible

Question 4

What is the problem with immunosuppressant dosing?

Answer 4

‘dose adjusted according to response’ - little attention paid to patient factors

Question 5

What is TPMT?

Answer 5

Thiopurine methyl transferase - metabolises azathiprone (one of the immunosuppressants)

Question 6

What is the effect of TPMT deficiency?

Answer 6

profound BM suppression leading to opportunistic infections, sepsis and death and GI effects - nausea, vomming and poor liver

Question 7

We can genotype TPMT deficiency

Answer 7

yayy

Question 8

What does detecting TPMT deficiency mean?

Answer 8

allows tailoring of azathiprine dose, lower rates of ADRs

Question 9

What are 6 probs with long term immunosuppression?

Answer 9

1)infection 2)cancer 3)CVD 4)recurrent disease 5)toxicity 6)hirsutism