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Z MD1 Renal block > Transplantation > Flashcards

Transplantation Flashcards

0
Q

what is an isograft

A

tissue between genetically identical identicals

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1
Q

what is an autograft?

A

move tissue from one part of the body to another

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2
Q

what is an allograft?

A

tissue transplantation between different members of the same species

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3
Q

what is a xenograft?

A

transplantation between members of different species

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4
Q

what is the cell responsible for transplant rejection and how?

A

T cells - recognise non-self antigens presented on MHC complexes

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5
Q

which chromosome is the MHC located on?

A

short arm of chromosome 6

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6
Q

which cells do the class 1 and class 2 MHC presenting to

A

1 - CD8 T cells

2 - CD4 T cells

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7
Q

what is the major transplant antigen

A

MHC molecules

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8
Q

what are the most important alleles on the MHC to match for transplantation

A

A, B and DR

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9
Q

graft survival of a solid organ transplant is directly related to

A

HLA matching

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10
Q

what is the dose response relationship with HLA mismatching

A

the more mismatches…. the worsening of long term graft survival

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11
Q

why arent lung and heart transplants HLA matches?

A

due to urgency

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12
Q

types of transplantation rejection and their timing

A

hyperacute - minutes-hours
acute - days-weeks
chronic - months-years

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13
Q

what is the cause of hyperacute rejection

A

preformed anti-donor antibodies and complement

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14
Q

what is the cause of acute transplant rejection

A

primary activation of T cells

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15
Q

what is the cause of chronic transplant rejection

A

causes unclear

Ab, immune complexes, slow cellular reaction, recurrence of disease

16
Q

what is another name for hyperacute rejection

A

antibody-mediated rejection

17
Q

what kinds of people would you test to see if they had preformed antibodies against MHC groups

A

people who have had a blood transfusion
previous pregnancy
previous transplant

18
Q

what is the mechanism behind antibody mediated rejection

A
  1. pre existing Ab are carried to graft
  2. Ab bind to antigen and activate C’
  3. C’ attracts neutrophils and release lytic enzymes
  4. destroys endothelial cells, platelets adhere to injured tissue –> vascular blockage
19
Q

mechanism of acute rejection

A
  1. immune cells pass through the new organ
  2. recognises non-self organ
  3. takes antigen to draining lymph node on MHC
  4. presents to T cells via APC
  5. T cells activated and proliferated
  6. immune related destruction
20
Q

how do you check whether you have acute rejection

A

take biopsies and look for T cell infiltrate

21
Q

what are the multiple hits that can cause chronic rejection

A 
ischaemia/reperfusion
dyslipidaemia
infection
hypertension
acute rejection
22
Q

what is the hallmark of of chronic rejection

A

fibrosis

23
Q

where does fibrosis normally occur in chronic rejection in renal, liver and lungs

A

around tubules

  • renal - around renal tubules (chronic allograft nephropathy)
  • liver - around bile duct (bile duct syndrome)
  • lungs - around airways (BOS)
24
Q

how do you try and prevent allograft rejection

A

Matching ABO antigens
matching MHC alleles
immunosuppressive drugs

25
Q

what is the action of cyclosporin

A

selectively takes out recently activated T cells

26
Q

what is the cocktail of drugs given to a transplant recipient

A

calcineurin inhibitors (eg cyclosporin)
anti-inflammatory (eg steroids)
anti-proliferative (eg azathioprine)

27
Q

how does cyclosporine inhibit T cells

A

prevents IL2 transcription needed for proliferation

28
Q

side effects of cyclosporon

A

nephrotoxicity

prone to viral infection

29
Q

action of azathioprine

A

inhibit T cell proliferation

30
Q

what is the concept of organ regeneration

A

organ put in detergent –> decellularize
then reconstitute the organ with the recipients own cells
transplant with no MHC

Z MD1 Renal block (8 decks)

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