Transplantation Flashcards

1
Q

Autograft:

A

From one part of the body to another.

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2
Q

Isograft:

A

Between genetically identical individuals.

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3
Q

Allograft:

A

Between different members of the same species.

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4
Q

Xenograft:

A

Between members of different species.

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5
Q

Direct recognition:

A

T cells may recognize allogeneic MHC molecules on the graft.

  • Displayed by donor dendritic cells in graft.
  • May be processed and presented by host dendritic cells.
  • T cells become activated.
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6
Q

Indirect recognition:

A

If graft cells are ingested by recipient dendritic cells.

- Donor alloantigens are presented by self MHC molecules on recipient APCs.

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7
Q

Hyperacute rejection:

A
  • Occurs within minutes or hours after transplant; surgeon can see this occur.
  • Antigen-antibody reaction; pre-formed antibodies.
  • Thrombotic occlusions of capillaries.
  • Fibrinoid occlusion of arterial walls.
  • Kidney cortex get infarction with necrosis.
  • Must be removed.
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8
Q

Acute rejection:

A
  • Occurs in days after transplant or much later if patient stops immunosuppression.
  • Both humoral and cellular mechanisms.
  • Can respond to increased immunosuppression.
  • Extensive mononuclear infiltrate.
  • Endothelitis: CD8 cells invade and damage vascular endothelium.
  • Called tubulointerstitial rejection
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9
Q

Chronic rejection:

A
  • Occurs months to years.
  • See slow rise in creatinine.
  • Vessels - dense intimal fibrosis that occludes the vessel lumen.
  • Interstitial fibrosis.
  • Tubular atrophy with loss of renal parenchyma.
  • Glomerular changes: chronic transplant glomerulopathy - duplication of basement membrane.
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10
Q

Graft-versus host disease:

A
  • Caused by the reaction of grafted T cells with alloantigens of the recipient.
  • Recipient is immunocompromised; unable to reject allogeneic cells in the graft.
  • Develops when significant numbers of T cells are transplanted.
  • Often directed to minor histocompatibility antigens.
  • Target organs are skin, liver and intestine.
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