Transplantation

Question 1

chronic transplant rejection - mechanism

Answer 1

CD4 T cells respond to recipient APCs presentinf donor peptides, including allogenic MCR –> cytokines –> cellular and homural compoments (type II and IV hypersensitivity reactions)

Question 2

chronic transplant rejection - results in / onset

Answer 2

cytokines –> proliferation of vascular SMCs, paremchymal atrophy, Interstitial fibrosis
DOMINATED BY ARTERIOSCLEROSIS
onset: month years

Question 3

chronic transplant rejection - example of organs and results

Answer 3

1. lung –> bronchiolitis obliterans
2. Heart –> accelerated atherosclerosis
3. Kidney –> chronic graft nephropathy
4. Liver –> vanishing bile duct syndrome

Question 4

Bronchiolitis obliterans?

Answer 4

bronchioles are compressed and narrowed by fibrosis (scar tissue) and/or inflammation –> life-threatening form of non-reversible

Question 5

Graft-versus-host-disease - Mechanism / onset

Answer 5

grafted immunocompompetent T cells proliferate in the immunocompromised host and reject host cells with “foreign” proteins –> severe organ dysfunction (type IV hypersensitivity reaction)
onset: varies

Question 6

Graft-versus-host-disease - requirements to occur

Answer 6

1. the graft must contain immunocommpoment T cells
2. the host must be immunocompromised
3. the recipient must express antigens (eg. MHC or other minor proteins) foreign to the donor

Question 7

Graft-versus-host-disease - clinical manifestation

Answer 7

1. maculopapular rash
2. jaundice
3. diarrhea
4. hepatsplenomegaly

Question 8

Graft-versus-host-disease - in transplantation of which organs

Answer 8

organs rich in lymphocytes:

–> esp a. bone marrow b. liver

Question 9

Graft-versus-host-disease - potentially beneficial for

Answer 9

bone marrow transplant form leukemia (graft-vs-tumor effect

Question 10

Graft versus tumor effect - definition

Answer 10

Donor T-cells eliminate malignant residual host T-cells (graft versus leukemia) or eliminates diverse kinds of tumors.

Question 11

transplant rejection - types, onset (time) and hypersensitvity reaction

Answer 11

1. hyperacute –> minutes –> type 2
2. acute –> weeks to months –> type II (humoral) or IV (cellular)
3. chronic –> months to years –> both IV and IV (humoral and cellular)
4. graft-vs-host disease –> varies –> type IV