Transplant rejection and Immunosupression Flashcards

1
Q

What is hyperacute rejection?

A

Recipient already has pre-existing donor specific antibodies (humoral response). Should NEVER happen.

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2
Q

What happens in a hyperacute rejection?

A

Antibodies activate he complement pathway and blood clotting cascade is initiated.

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3
Q

When does a hyperacute rejection become noticed?

A

Within minutes of transplantation

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4
Q

What is an acute rejection?

A

When HLA is mismatched and endothelial cells are attacked by cytotoxic T cells.

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5
Q

What is activated in an acute rejection?

A

T lymphocytes.

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6
Q

How long until an acute rejection is noticed?

A

Several days.

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7
Q

How can an acute rejection be prevented?

A

HLA matching and immunosupressants.

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8
Q

What are de novo DSAs in an acute rejection?

A

Donor specific Antibodies detected after transplantation. Cause antibody-dependent and cell-mediated cytotoxicity.

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9
Q

What is an acute rejection ALWAYS due to?

A

Vascular endothelial damage!

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10
Q

What is a chronic rejection?

A

Always happens to some degree. Multiple immune mechanisms, cell mediated and humoral.

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11
Q

What does a chronic rejection eventually lead to?

A

Vascular disease.

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12
Q

Which immune components can be involved in chronic rejection?

A

Lymphocytes, Phagocytes, Antibodies, Complement

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13
Q

Stages of chronic rejection?

A

Allo-antibodies bind to endothelial cells and recruit Fc-receptors.

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14
Q

What do Fc-receptors have?

A

Monocytes.

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15
Q

Where are inflammatory components located in chronic rejection?

A

Vessel wall

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16
Q

What do inflammatory components cause in chronic rejection?

A

Damage of wall, thickening of blood vessel and narrow lumen. Inadequate blood supply.

17
Q

How long does chronic rejection happen for?

A

10 years post-transplant.

18
Q

What is the need for immunosuppressive drugs?

A

Required for allogenic transplant to survive.

19
Q

ha caused patient infection deaths in he 1950’s? (immunosuppressive drugs)

A

Sub-lethal doses of total body irradiation (TBI) and cortisone. (Destroys the immune system)