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R - Immunology (Rach and Meg) > Transplantation > Flashcards

Transplantation Flashcards

1
Q

autologous transplant

A

the transplant tissue is from the same individual e.g. skin graft

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2
Q

syngeneic transplant

A

between twins

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3
Q

allogenic transplant

A

between genetically non-identical members of the same species

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4
Q

xenogenic transplant

A

between different species

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5
Q

cadaveric transplant

A

organs from dead donor

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6
Q

what is rejection

A

when the immune system attacks the transplant

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7
Q

what can reduce the risk of rejection

A

donor and recipient must be AOB compatible close as possible HLA match recipient must not have anti-donor HLA antibodies immunosuppression

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8
Q

what is hyperacute rejection

A

immune system rejects organ/translant within hours

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9
Q

pathophysiology of hyperacute rejection

A

antibodies bind to ABO blood group or HLA class I antigens on the graft type II hypersensitivity reaction is triggered IgG and IgM bind and recruit macrophages and complement system causing cell damage

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10
Q

acute rejection

A

delayed type IV hypersensitivity reaction days-weeksusually due to HLA incompatibility

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11
Q

pathophysiology of acute rejection

A

dendritic cells from donor stimulate an allogenic response in lymph node node releases T cells which target donor organ

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12
Q

afferent phase of acute rejection

A

donor MHC molecules on dendritic cells recognised by patients CD4+ T cells

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13
Q

efferent phase of acute rejection

A

T cell recruit macrophages< NK cells, B cellsgraft is targeted

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14
Q

what is chronic rejection

A

takes place over months/years often mediated by T cells can be caused by pre-existing autoimmune disease

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15
Q

role of immunosuppresants in transplants

A

prevent rejection at the time of the transplant if the drugs are stopped rejection will occur

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16
Q

role of corticosteroids in transplants

A

low dose prevent early stages of rejection target antigen presenting cells at a high dose they can treat rejection

17
Q

how does ciclosporin work

A

immunosuppressant interacts with proteins in T cell signalling cascade

18
Q

examples of monoclonal antibodies

A

basiliximab daclizumab

19
Q

role of monoclonal antibodies in transplants

A

used in acute graft rejection

20
Q

rapamycin mechanism of action

A

inhibits signals from IL-2 receptor

21
Q

role of rapamycin in transplants

A

prevents acute graft rejection

22
Q

side effects of rapamycin

A

raises lipid and cholesterol levels anaemia hypertension rash thrombocytopenia

23
Q

what are anti-proliferatives

A

drugs that inhibit DNA production

24
Q

anti-proliferatives examples

A

azathioprine mycophenolate mofetil methotrexate

25
Q

stem cell sources for transplant

A

bone marrow peripheral bloodcord blood

26
Q

when is stem cell transplantation used

A

last resort for haematological malignancies primary immunodeficiency severe combined immunodeficiency

27
Q

autologus stem cell therapy

A

marrow is removed frozen and reinfused after chemotherapy has been given

28
Q

allogenic stem cell therapy

A

higher risk risk of graft vs host disease

29
Q

what is conditioning for SCT

A

high dose chemo/radiotherapy to destroy stem cells before new ones are given

30
Q

what is graft vs host disease

A

multi-system complication of allogenic bone marrow transplantationT cells respond to allogenic recipient antigens

31
Q

what is the billingham criteria

A

criteria used to diagnose graft vs host disease

32
Q

three requirements to meet the billingham criteria

A

transplanted tissue has immunologically functioning cells recipient and donor are immunologically differenr recipient is immunocompromised

33
Q

when does acute graft vs host disease happen

A

within 100 days

34
Q

features of acute graft vs host disease

A

affects skin, liver, GImaculopapular rashjaundicewatery/bloody diarrhoea nausea vomiting fever

35
Q

features of chronic graft vs host disease

A

any organ system can be involved scleroderma vitiligo corneal ulcers scleriti dysphagia oral ulcers oral lichenous changes obtructive or restrictive lung disease

36
Q

what drugs would you use in graft vs host disease

A

immunosuppressants

37
Q

how can hyperacute rejection be triggered in xenotransplantation

A

humans make antibodies against sugar side chains that they are exposed to in the gut the antibodies can target the organ and activate the complement system

R - Immunology (Rach and Meg) (11 decks)

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