Transplant

Question 1

What is the cause of transplant rejection?

Answer 1

Allogeneic differences… can be overcome.

Question 2

What are the rejection causes in host vs graft responses?

Answer 2

Differences in major HLA antigens, host T-cells recognizing the graft HLA, recipient T-cells recognize donor minor HLA antigen.

Question 3

What are the graft vs host reaction?

Answer 3

Results from donor lymphocytes attack the graft recipient causing graft vs host diseast (GvHD). Observed in Bone marrow transplant… requires removal of all donor T cells.

Question 4

Allograft

Answer 4

Between different members of the same species…usually rejected.

Question 5

Autograft

Answer 5

From one part of the body to another on same person..accepted.

Question 6

Isograft

Answer 6

Between genetically identical individuals…accepted.

Question 7

Xenografts

Answer 7

Between members of two different species.

Question 8

Hyperacute rejection

Answer 8

Occurs within minutes to hours and is antibody mediated

Question 9

Acute rejection

Answer 9

Occurs days to weeks and occurs alloreactive T cells.

Question 10

Chronic rejection

Answer 10

Occurs months to years.

Question 11

Direct allorecognition

Answer 11

Donor antigen presenting cells present peptides to recipient T-cells

Question 12

Indirect allorecognition

Answer 12

Donor cell that die and are phagocytosed by recipient cells then presented for immune response.

Question 13

Donor-recipient compatibility

Answer 13

ABO blood type, recipient must not have anti-donor HLA antibodies, close match of HLA.

Question 14

What is tissue typing?

Answer 14

Matching the HLA from recipient to donor

Question 15

HLA 1 subclasses

Answer 15

HLA-A, HLA-B, HLA-C

Question 16

HLA 2 subclasses

Answer 16

HLA-DQ, HLA-DR, HLA-DQ

Question 17

Tissue cross-matching

Answer 17

Determines is recipient has antibodies against donors WBC. Recipient serum mixed with donor leukocytes.

Question 18

Contra indicated

Answer 18

In the case of positive tissue cross matching then transplant is contra indicated.

Question 19

General function of immunosuppressive drugs

Answer 19

Affect T-lymphocyte or affect T and B cell lymphocyte. Increase risk of opportunistic infections.

Question 20

Calcineurin inhibitors

Answer 20

Inhibits calcineurin enzyme and inhibits activation of transcription factor NFAT in T cells. Blocks IL-2 production. IL-2 stimulates T cells and differentiation of T cells. Prevents T cell activation.

Question 21

Mammalian target of rapamycin inhibitor

Answer 21

Inhibition of IL-2 driven proliferation of T cells.

Question 22

Anti-T cell immunoglobins

Answer 22

Antibodies that bind to T lymphocytes. Phagocytosis of T cells.

Question 23

Anti-CD3 antibody

Answer 23

Binds CD3 to prevent T cell activation

Question 24

IL-2 receptor antagonist

Answer 24

Binds to IL-2 receptor so no T cell proliferation

Question 25

Antimetabolites

Answer 25

Blocks T and B cell division. Inhibits purine synthesis and cell proliferation.

Question 26

Corticosteroids

Answer 26

Decrease inflammation and T cell migration and PMN migration

Question 27

Oral graft versus host disease (GVHD)

Answer 27

Is common and causes morbidity and loss of quality of life in transplant patients.

Question 28

Oral graft versus host disease symptoms

Answer 28

Lichenoid changes, mucosal atrophy and ulcerations, taste disturbances, and salivary gland hypofunction that leads to dental caries and candidal superinfections. Oral pain leads to weight loss.

Question 29

Drugs that suppress T cells

Answer 29

Tacrolimus/FK-506, cyclosporine and tacrolimus. Sirolimus, rapamycin, Murononab, daclizumab, basiliximab.

Question 30

Antimetabolites drugs

Answer 30

azathioprine, mycophenolate mofetil,

Question 31

Corticosteroids drugs

Answer 31

prednisone, methylprednisolone