Renal Transplatation

Question 1

Patients having an organ transplant are at risk of what cancer and why?

Answer 1

Skin Cancer, esp squamous cell carcinoma due to long term immunosuppressant use

Question 2

Acute rejection of a renal transplant occurs at what time from transplantation? How is it acutely treated?

Answer 2

Within 6 months

Corticosteroids

Question 3

What are the main antigens which give rise to transplant rejection?

Answer 3

ABO blood group
HLA
MHC

Question 4

Chronic rejection of a renal transplant occurs at what time from transplantation?

Answer 4

> 6 months post transplantation

Question 5

Hyperacute organ rejection is mediated by what?

Answer 5

ABO antigens

Question 6

Acute organ rejection is mediated by what?

Answer 6

T-cells

Question 7

How are patients matched for a renal transplant?

Answer 7

Human leukocyte antigen A, B and C (HLA) on chromosome 6.

Question 8

What are patients given before renal transplantation?

Answer 8

Treatment to desensitise them to the donor HLA in preparation for transplant

Question 9

What drug is given to prevent acute rejection?

What is the MoA of this drug?

Answer 9

2 doses of Basiliximab after surgery to prevent acute rejection

Monoclonal antibody binding to IL-2 receptors on T cells

Question 10

What side effects do these four each cause?

• All immunosuppressants?
• Tacrolimus?
• Cyclosporin
• Steroids

Answer 10

• Seborrheic warts/skin cancers
• Tacrolimus - tremor
• Cyclosporin - gum hypertrophy
• Steroids - Cushing’s syndrome

Question 11

What do these three have in relation to renal transplant?

• Pneumocystis jiroveci pneumonia
• Cytomegalovirus (CMV)
• TB

Answer 11

They are oppourtunistic infections that may occur secodnary to long term immunosuppression