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immunology > transplantation > Flashcards

transplantation Flashcards

1
Q

rejection

A

damage done by immune system to a transplanted organ

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2
Q

different kinds of transplant

A
  • autologous
  • syngeneic
  • allogeneic
  • cadaveric
  • xenogeneic
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3
Q

solid organ transplant criteria

A

no alternative treatment

damage is irreversible

disease must not recur

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4
Q

risks of rejection

A

incompatible ABO

anti-donor human leukocyte antigen antibodies

no immunosuppressive treatment

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5
Q

types of rejection

A

hyperacute rejection

acute rejection

chronic rejection

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6
Q

hyperacute rejection

A

within hours

preformed antibodies bind to either ABO blood group or HLA class I antigens on graft

type II hypersensitive reaction and graft destroyed by vascular thrombosis

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7
Q

acute rejection

A

within few days or weeks

donor dendritic cells stimulate an allogeneic response in local lymph node and T cells proliferate and migrate to donor kidney

type IV reaction

main cause: HLA incompatibility

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8
Q

chronic rejection

A

months or years

recurrence of pre-existing autoimmune disease

allogenic rejection often mediated by T cells which can result in repeated acute rejection

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9
Q

phases of graft rejection

A

afferent: donor MHC molecules on dendritic cells within graft recognised by recipients CD4+ T cells
effector: CD4+ T cells recruit effector cells responsible for the tissue damage of rejection; macrophages, CD8+ T cells, NK cells and B cells

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10
Q

tolerance in the context of transplantation mean?

A

no response to alloantigen’s present on transplanted tissue but responses to pathogens not affected

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11
Q

How is tolerance achieved in transplantation?

A

Achieved with immunosuppressant drugs:

  • Prevent rejection if given at the time of transplantation
    • Once stopped, rejection still takes place
  • Lacks specificity of true tolerance and thus also prevents immune response to infectious agents
    • Opportunist infections are major limit to use of potent immunosuppressive drugs
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12
Q

tissue typing

A

procedure in which tissues of prospective donor and recipient are tested for compatibility

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13
Q

steps in tissue typing

A

HLA typing: at the A, B and DR loci

HLA cross matching

  • Information put into registry of donors and compared
  • If identify match, further typing occurs
  • Matching test done to confirm as typing rarely perfect match
    • B cells from donor taken (as expressed class 1 and 2 of HLA), then mixed with serum from recipient (has antibodies), looking for no reaction
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14
Q

stem cell transplantation

A

haematopoietic stem cells used to restore myeloid and lymphoid cells

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15
Q

different kinds of stem cell transplantation

A
  • autologous
  • allogenic
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16
Q

when is allogenic SCT carried out?

A

haematologic malignancy with no alternative treatment

  • myeloid cell production is reduced eg aplastic anaemic
  • primary immunodeficiencies eg severe combined immunodeficiency
17
Q

different sources of stem cells

A
  • bone marrow
  • peripheral blood
  • cord blood
18
Q

what is done to destroy recipients own stem cells to allow engraftment of donor cells?

A

high dose chemotherapy

high dose radiotherapy

19
Q

graft versus host disease

A

donor T cells respond to allogeneic recipient antigens

  • mismatches in major or minor histocompatibility antigens
20
Q

graft versus host disease prevention

A

all patients given immunosuppressive drugs, even if donor and recipient are HLA identical

21
Q

organs involved in GVHD

A

acute (occurs up to 4 weeks after SCT): skin, gut, liver and lungs

chronic: skin and liver

22
Q

different classes of immunosuppresive drugs?

A

corticosteroids

T-cell signalling blockade

IL-2 blockade

  • monoclonal antibodies against IL-2 receptor, rapamycin

antiproliferatives

23
Q

For T cell signalling blockade drugs:

  • drug names
  • mechanism
A
24
Q

For IL-2 blockade drugs:

  • names
  • mechanism
  • indication
A
25
Q

For rapamycin:

  • administration
  • mechanism
  • indication
A
26
Q

For antiproliferatives:

  • names
  • mechanism
  • side effects
A
27
Q

myelotoxicity?

A

bone marrow suppression

immunology (11 decks)

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