Thrush- Transplantation Flashcards

1
Q

fist human kidney transplant occurred in russia and pt died because of ____ type mismatch. First successful kidney transplant was between identical twins

A

blood;

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2
Q

What are the commonly transplanted organs

A
  1. kidney
  2. pancreas
  3. heart
  4. lung
  5. bone marrow
  6. cornea
  7. skin (autologous)
  8. liver
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3
Q

___ is self tissue transferred form one site to another in the same ind. ____ is tissue transferred from genetically identical inds. ____ is tissue transferred bet genetically distinct ind’s of the same species. ____ is tissue transferred between different species.

A

autograft; isograft; allograft; xenograft

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4
Q

Graft rejection is due to ____ and ____. first set rejection takes place 1-2 weeks for immunological recognition and rejection. (primary immune response). Second set rejection occurs if you put the same tissue on ind again, then see a quicker rejection. (memory response)

A

specificity; memory

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5
Q

____ by themselves play a significant role in rejection. If you get rid of CD4 cells you can prolong the survival of that particular translated tissue.

A

CD4

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6
Q

If you throw Ab to both CD4 and CD8 you can extend survival up to ___ days.

A

60

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7
Q

what happens during alloreactive activation

A

where IS recognizes allotypic diff’s form one human to another. They activate CD4 and CD8 cells and destroy tissue

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8
Q

the alloreactive activation and host DC’s cleaning up mess is part of the _____ phase

A

sensitization

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9
Q

___ cleans up mess , if Ag is diff between donor and recipient, you’ve activated T helper cells to stimulate B cells to destroy tissue.

A

host DC’s

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10
Q

what is part of the effector stage

A
  1. Delayed type hypersensitivity cells: promote inflammation
  2. Cytotoxic T lymphocytes: mediate cytotoxicity; recognize graft cells.
  3. IL-2: T cell proliferation and CTL activation
  4. IFN-gamma: DTH response, recruitment of macrophages
  5. TNF-beta: directly cytotoxic to graft cells.
  6. ADCC- Ab brings in NK cells, eosoinpils etc and release lytic components
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11
Q

T helper cell can produce cytokines to produce direct _____.

A

cytoxicity; direct lysis

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12
Q

What are the 3 major categories of rejection

A
  1. acute rejection
  2. hyperacute rejection
  3. chronic rejection
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13
Q

describe acute rejection

A
  1. takes 2-4 weeks after transplant
  2. once initiate rejection, usually quickly proceeds (CTL and DTH)
  3. usually due to differences in classical MHC genes.
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14
Q

____ rejection almost has immediate rejection. Due to preformed Ab which can stimulate complement activation.

A

Hyperacute

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15
Q

Which patients are more prone to hyper acute rejections

A
  1. patients with repeated blood transfusions (potential exposure to graft antigens)
  2. women who have had many pregnancies (exposure to paternal alloantigens from fetus)
  3. patients given a previous graft
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16
Q

______ is the slowest and least vigorous and is due to ____ histocompatibility antigens which can stimulate an immune reaction and cause rejection of transplanted tissue.

A

chronic; minor

17
Q

Immunosuppressive drugs help stop ___ rejection but not chronic.

A

acute

18
Q

because humans are an outbred population and the fact that the MHC genes are ____ there is a small chance that two people will be histocompatible

A

polymorphic

19
Q

the ____ loci codes for proteins that play the biggest role in graft survival.

A

MHC

20
Q

class ____ MHC matches are more important that class I.

A

II

21
Q

____ type differences are the other major factor for graft success.

A

blood

22
Q

blood group antigens are expressed on RBCs, epithelial cells, and ____ cells

A

endothelial

23
Q

If there is no diff in class II and if there are slight diff in class I there is still survival of transplant. But if there is a diff in class ____, and class I there is more rejection.

A

II

24
Q

how do you insure graft survival?

A
  1. blood type match
  2. MHC matching
    3.
25
Q

skin you have to have the best match possible, also with kidney and bone marrow. You don’t have to have as much match with ____ and ____ transplants

A

liver; heart

26
Q

Graft (donor) tissue is rejecting host cells. This causes pathology in the skin, liver, and GI tract. If you partially remove donor _____ cells it can lessen the chance of getting a reaction.

A

T

27
Q

what are mitotic inhibitors

A

general drugs that stop/slow cell division–> slow rejection. But problems: also slowing down recognition of infectious agent. (weaken the IS)

28
Q

what are corticosteroids

A

antiinflammatory agents; suppress B and T cell activation.

29
Q

what are the immunosuppressants for graft survival

A
  1. mitotic inhibitors
  2. corticosteroids
  3. fungal metabolites: block IL-2 and IL-2R
  4. antibodies (used for specific targets)
30
Q

what are the Ab to treat donor/graft tissue

A
  1. anti CD3 (block T cell activation)
  2. anti CD25
  3. anti CD20
  4. CTLA4-Ig (prevents CD28 from interacting)