Transplantation Flashcards
ABO just in blood?
nope other systems as well, so try to match for transplant as well
isograft? allograft? xenograft?
iso: identical twin
allograft: same species
xenograft: different species
1st of 2nd graft more tolerated?
1st graft.
which immune cell is responsible for rejection?
T-cell
T-cells recognize what?
MHC I : universally expressed (CD8)
MHC II : APC inducible (CD4)
MHC genes are static?
Nope. highly polymorphic
HLA matching of how many usually?
6
Renal vs. Lung transplant which one has more HLA mismatches?
Lung because of time and shorter waiting list
3 types of rejection are?
antibody mediated: immediate
acute: days-weeks: T-cells
Chronic: months-years: Ab? immune complexes? viruses?
what helps to determine what preformed antibodies you have?
blood MHC blood transfusions preg transplant
what happens if you get early episodes of acute rejection?
more problem with chronic rejection in future
2 non-immunological causes of chronic rejection?
viruses, ischaemia-reperfusion injury
what happens histologically in chronic rejection?
scarring/fibrosis around tubules etc.
chronic allograft rejection what can happen in:
Kidney?
Liver?
Lung?
nephropathy
scarring of bile ducts
bronchiolitis obliterans syndrome
hyperacute rejection mediated by?
antibodies and complement
3 ways to prevent rejection?
match ABO
match MHC/HLA
immunosuppresive drugs
oldes immunosuppressive drug?
azathioprine
what drug is good at taking out recently activated T-cells?
cyclosporin
cyclosporin and tacrolimus inhibits what?
calcineurin
what do calcineurin inhibitors leave you vulnerable to?
viruses
steroids for anti-rejection for what?
decrease lymphocytes and reaction to antigens but more risk of infection
what does azathioprine do?
non-specifically inhibits DNA and RNA synthesis, blocks IL2 prod
do we just use one drug for immunosuppression ? why?
use cocktail, so what you can use lower doses of the individual drugs and minimize side effects
organ regen involves?
decellularize a donor organ to get scaffolding, then populate with recipient cells to grow
