Transplantation Flashcards
1
Q
What is immune tolerance
A
A state of unresponsiveness of the immune system to self
2
Q
Describe immediate rejection
A
- Happens in minutes
- ABO/HLA-antibodies
- Complement activation damages blood vessels
- Inflammation + thrombosis
3
Q
Describe acute rejection
A
- Within 1-6mths
- Mix of cell + antibody mediated
- Cellular infiltration of graft by Tc-cells, B-cells, NK cells + macrophages
- Endothelial inflammation and parenchymal cell damage
4
Q
Describe chronic rejection
A
- Commonest cause of graft failure
- > 6mths
- Antibody mediated with other innate components
- Myointimal proliferation in arteries
5
Q
Rx of rejection
A
- Corticosteroids
- Anti-thymocyte globulin
- Plasma exchange
6
Q
How to prevent graft rejection
A
- ABO matching
- Tissue typing (Class I & II HLA)
- Prohphylactic immunosuppresion
7
Q
3 immunosuppressive drugs
A
- Prednisolone (corticosteroids)
- Tracrolimus (calcineurin inhibitors)
- Anti-proliferatives (MMF)
8
Q
What type of transplant is graft vs host disease common
A
Bone marrow transplant
9
Q
How to prevent graft vs host disease
A
- Donor/recipient matching
- Donor marrow T-cell depletion
