Transplant Rejection Treatment Flashcards
1
Q
What are the 5 types of organ rejection?
A
- Hyperacute
- Acclerated Acute
- Acute
- Chronic
- Graft vs Host Disease
2
Q
What is hyperacute organ rejection?
A
- Rare, occurs within minutes of transplant (in the OR), is humorally mediated.
- Leads to rapid tissue necrosis and death of the transplanted organ.
3
Q
What is accelerated acute organ rejection?
A
- occurs 1-5 days post operatively
- cellularly and humorally mediated
- difficult to treat
4
Q
What is acute organ rejection?
A
- cellularly mediated in 90% of cases
- typically occurs within the first few months after surgery but can occur at any time. It is amenable to treatment.
- Monitoring for rejection is strict in all types of solid organ transplant with appropriate assessment of transplanted organ (e.g., creatinine in kidney, LVEF in heart, etc)
5
Q
What is chronic organ rejection?
A
- cell-mediated and humorally-initiated injury to the endothelium and vascular bed.
- It occurs slowly and eventually leads to loss of transplant function.
- There is no definitive treatment.
- Patients with chronic rejection are considered for re-transplant if there are no contraindications. It is highly likely that the PRA will be elevated in these patients making finding a suitable organ more difficult.
6
Q
What is graft vs host disease?
A
uncommon in solid organ transplants (more common in stem cell transplants) but if it occurs it can be fatal
7
Q
What is the gold standard in diagnosing transplant rejection?
A
Gold standard of diagnosis for rejection is biopsy of the transplanted organ.
8
Q
What are the signs and symptoms of transplant rejection?
A
9
Q
What is given to treat transplant rejection?
A
- Treatment includes high dose corticosteroids, optimizing the maintenance immunosuppressive regimen and anti-lymphocytic therapy
- Maintenance immunosuppression therapy typically includes a calcineurin inhibitor, a corticosteroid and an antimetabolite
