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Immunology Spring 2 > Transplant Immunology > Flashcards

Transplant Immunology Flashcards

1
Q

What is transplant rejection?

A

Destruction of grafted tissues by immune responses caused by genetic differences between the donor and the recipient

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2
Q

Define allogenic

A

Individuals of the same species who are genetically different

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3
Q

What gives rise to most allotypic antigens?

A

Polymorphic genes (MHC class I and II molecules; blood group antigens)

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4
Q

Define autograft

A

Graft of tissue from one site to another on the same patient

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5
Q

Define syngeneic graft

A

Graft between genetically identical patients (isograft)

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6
Q

Define zenograft

A

Graft between two different species

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7
Q

Attack by what type of cell leads to transplant rejections (tissues) or graft-versus-host disease (bone borrow)?

A

T-Cells

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8
Q

What is the most common type of tissue transplant?

A

Blood transfusions

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9
Q

Do erythrocytes express MHC class I or II molecules?

A

Neither

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10
Q

What are the primary targets of alloreactivity for blood transfusions?

A

The A, B, and O antigens (also think about Rh factor)

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11
Q

What blood type is the universal donor? Why? Universal acceptor?

A

Blood type O, because it is the basis for both A and B.

Blood type AB, because it has no specific antibodies against A or B

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12
Q

Which Rh factor is of largest concern?

A

Rh D Antigen

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13
Q

When does hyperacute rejection occur?

A

When donor tissue comes from a person whose blood-type is not compatible with the recipient. (ex A donating to B)

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14
Q

What mediates hyperacute rejection?

A

It is mediated by preformed antibodies of the recipient that is specified for alloantigens of the grafted tissue

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15
Q

What happens in a hyperacute rejection?

A

Vascular endothelium expressing the same blood group antigens that are expressed on erythrocytes bind to each other and initiate the complement and clotting cascades

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16
Q

What is the effector mechanism of hyperacute reaction?

A

IgG and IgM directed against A, B, and O antigens

17
Q

What mediates an acute rejection?

A

Effector CTL’s responding to allotypic differences between blood and donor; MHC class I and II are most polymorphic genes in genome

18
Q

Why does an acute rejection take longer than a hyperacute rejection?

A

About 11-15 days after transplantation because there are no preformed effector cells (must prime and generate new CD8+ T cells)

19
Q

What is a nude mouse?

A

A mouse with an athymic phenotype (cannot produce mature T cells so cant reject a zenograft)

20
Q

What is second set rejection?

A

An accelerated acute response because an immune response is already primed from first graft

21
Q

Can a rejection occur from identical HLA haplotypes?

A

Yes, and it is mediated by minor histocompatibility complexes

22
Q

How long does a rejection from identical HLA haplotypes take?

A

Much longer, 30-60 days

23
Q

If we improve HLA matching between donor and recipient, does this help the transplant?

A

Yes, the closer the match the better (done by serological and DNA techniques)

24
Q

Which HLA types are of the most concern?

A

HLA-A, HLA-B, HLA-DR

25
Q

What needs to be matched for a liver transplant?

A

Blood antigen; Liver transplant doesn’t depend on HLA matching, liver is refractory to acute rejection

26
Q

What needs to be matched for a corneal transplant?

A

Nothing! Cornea is not vascularized

27
Q

What are Rh antigens?

A

A complex set of protein alloantigens expressed on RBC’s

28
Q

When do we worry about Rh antigens during pregnancy?

A

The pregnancy of an Rh- woman carrying an Rh+ baby; dont want the mother to make antigens against the Rh antigens, more concerned in second pregnancy than first

29
Q

When do immune responses form when an Rh- mother is carrying an Rh+ baby?

A

Not until after birth when the mother is exposed to a large amount of the baby’s blood

30
Q

Subsequent pregnancies of an Rh+ baby to an Rh- mother lead to what?

A

Hemolytic disease of the newborn

31
Q

What is Rhogam? When is it administered?

A

It is an anti-RhD antibody administered after birth that will precent the mother from mounting an Rh- specific immunity

32
Q

T/F, Rhogam is administered to mothers that have different blood types than the baby.

A

False, give to mothers with the same blood type

33
Q

Are blood group antigens expressed more on vascular endothelium or RBCs?

A

Vascular endothelium

34
Q

What is graft-versus-host disease (GVHD)?

A

A mature T-cell attack on the recipient’s tissue occurring after bone marrow transplant. More widespread than transplant rejection.

35
Q

What are the principle tissues effected by GVHD?

A

Skin, intestines, and liver (inflammation of bile duct)

36
Q

What are the grades of GVHD?

A

I-IV on the basis of skin, liver, and GI tract involvement

37
Q

How can we prevent GVHD from occurring?

A

Deplete all of the mature T cells from the bone marrow of the donor; immunosuppressive drugs

38
Q

Why am I not including any information about drugs from Miller?

A

He is not testing us on them, learn drugs for the other professors.

Immunology Spring 2 (7 decks)

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