Translplants - b cell Flashcards
3 phases of antibody mediated rejection
Phase 1 - B cells recognise
Phse 3 -this is in the ENDOTHELIUM whereas in t-cell mediated, the t-cells go through the interstitium and cause tubular disease
What ways do antibodies use to cause injury?
Complement activated - cause holes in the endothelium, can also recruit other cells, and release cytokines
Complement independent
you essentially get loads of cells in the endothelium of the kidney, causing damage
This causes glomerulitis
Which type of rejection is harder to treat?
T cell mediated injury gets better, and the creatinine comes down
Antibody mediated rejection - harder to treat
Are anti-HLA antibodies naturally occuring? When do they occur?
No - they are either pre-formed during pregnancy, transfusion
Or they are formed after transplantation
What are the three types of essays used to test for anti-HLA antibodies after transplantation?
Cytotoxicity assay
Flow cytometry
Solid phase assays (using synthetic beads coated with different HLA
Plasma exchange
Viral infections after
BK nephropathy
Acute t-cell mediated rejection treatment
Steroids - prednisolone
If the recipient has a detectable antibody in the serum against a HLA type, is this high risk or low risk transplantation?
High risk as they already have