Transplantation

Question 1

What blood type is the universal acceptor?

Answer 1

AB

Question 1

Why do antibody-mediated rejections occur so fast?

Answer 1

The antibody is already there

Question 1

Which individuals are more likely to get antibody rejections?

Answer 1

Those who’ve had blood transfusion, pregnancies or previous transplants (previous exposure to different MHCs)

Question 3

Who performed the first kidney transplant?

Answer 3

Joseph Murray

Question 4

What is advantageous about using a combination of immunosuppressive drugs?

Answer 4

You can use small doses of each to reduce side effects

Question 5

Which blood type is the universal donor?

Answer 5

O

Question 5

What are the 3 types of rejections?

Answer 5

Hyper-acute aka antibody-mediated rejection

Acute

Chronic

Question 6

What are three ways of preventing graph rejection?

Answer 6

Match blood group

Match MHC

Immunosuppressive drugs

Question 7

What pathological process occurs in chronic rejection of kidney transplants?

Answer 7

Fibrosis and scarring > Intimal fibrosis > Loss of tubules

Question 7

What is the current direction of transplant research?

Answer 7

Better immunological matching

More specific immunosuppression

Xenotransplantion

Induction of tolerance

Stem cell transplantation

Question 8

What is the mechanism of action of azathioprine?

Answer 8

Inhibition of cell proliferation

Question 10

What is the difference between an allograph and an isograph?

Answer 10

An isograph is from a genetically identical person

An allograph is from a genetically different person from the same species

Question 12

What immune cell is responsible for rejection?

Answer 12

T cells

Question 13

Why is cyclosporin an more selective immunosuppressor?

Answer 13

It targets recently activated T cells

Question 13

How do calcineurin inhibitors downregulate activated T cells?

Answer 13

Downregulate expression of IL-2

Question 14

How is inflammation amplified in antibody-mediated rejection?

Answer 14

Antibodies bind to the donor MHC which initiates complement

Question 15

Which molecule is the major driver of graph rejection?

Answer 15

MHC

Question 15

What three drugs are used in the immunosuppression cocktail?

Answer 15

Anti-inflammatory eg steroids

Anti-proliferative eg azathioprine

Calcineurin inhibitors eg cyclosporin

Question 17

What was the original immunosuppressive drug used in transplants?

Answer 17

Azathioprine

Question 18

What are some risk factors for the development of chronic rejection?

Answer 18

Episodes of acute rejection

Ischaemia/reperfusion

Dyslipidaemia

Infection

Hypertension

Question 19

What infections do calcineurin inhibitors leave you prone to?

Answer 19

Viral

Question 21

What is another calcineurin inhibitor apart from cyclosporin?

Answer 21

Tacrolimus

Question 22

Why is it harder to MHC match lung and heart transplants?

Answer 22

There are less donors available and less time

Question 23

Which chromosome encodes MHC?

Answer 23

6

Question 25

What is the mechanism for acute rejection?

Answer 25

T cell activation against donor ag’s > T cell mediated response

Question 26

How do anti-proliferative drugs work?

Answer 26

Inhibit RNA and DNA synthesis

Block IL-2 synthesis and T cell expansion