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Haematology and Immunology > Transplantation > Flashcards

Transplantation Flashcards

1
Q

What are the different types of grafts?

A

Xenograft
Allograft
Autograft
Isograft

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2
Q

What is immune tolerance?

A

A state of unresponsiveness of the immune system to self

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3
Q

What and where does central immune tolerance occur?

A

Occurs in thymus

Inactivation of cells required for initiation of an immune response

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4
Q

What is peripheral immune tolerance?

A

Inhibition of expression of the immune response

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5
Q

What is histocompatibility?

A

Property of having the same or sufficiently similar alleles of a set of genes called human leukocyte antigens (HLA)

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6
Q

What are the features of HLA class 1?

A

CD8+/Tc cells recognise

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7
Q

What are the features of HLA class 2?

A

CD4+/Th cells recognise

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8
Q

What are “privileged” transplant sites?

A

No sensitisation/tolerance
No requirement for tissue matching
No immunosuppression

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9
Q

What are the causes of graft rejection?

A

ABO or HLA incompatible
Pre-formed immunity
Failed immunosuppression
Infections/environmental triggers

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10
Q

What are the features of immediate rejection?

A

Can happen in minutes
ABO/HLA antibodies
Complement activation damages blood vessels
Inflammation and thrombosis

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11
Q

What happens in the acute rejection process?

A

CD4 and CD8 cells recognise alloantigens
T cell receptors react with APCs via MHC molecules
Co stimulation via CD28, CD80, and CD4/40 surface ligands

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12
Q

What are the features of acute rejection?

A

Cellular infiltration of graft by Tc cells, B cells, NK cells and macrophages
Endothelial inflammation and parenchymal cell damage

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13
Q

What are the features of chronic rejection?

A

Antibody mediated with other innate components

Myointimal proliferation in arteries

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14
Q

What is the treatment for rejection?

A

Corticosteroids
Anti-Thymocyte Globulin
Plasma Exchange

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15
Q

What are the other complications of transplantation?

A 
Infection 
Neoplasia (skin, lymphoma) 
Drug side effects 
Recurrence of original disease 
Surgical, ethical problems
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16
Q

How can graft rejection be prevented?

A

ABO matching
Tissue Typing (Class I & II HLA)
Prophylactic immunosuppression

17
Q

What immunosuppression medication is used to prevent graft rejection?

A 
Corticosteroids (prednisolone) 
Calcineurin inhibitors (tacrolimus) 
Anti proliferatives  (MMF)
18
Q

What are the features of graft versus host disease?

A

Immunocompetent cells in graft
Defective recipient immunity
HLA differences between donor and recipient

19
Q

What is the prevention for graft versus host disease?

A

Donor/ recipient matching

Donor marrow T cell depletion

20
Q

How can graft rejection be prevented in xenografts?

A

Remove antibody from recipient
Genetically modified pigs
Humanised transgenic pigs

Haematology and Immunology (16 decks)

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