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SGU Immuno Post MT: Transplantation
SGU Immuno Post MT: Transplantation
47
Medical
Professional
01/05/2013

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Term
What is transplantation ?
Definition
Refers to engraftment of cells or tissues from one individual donor to another recipient/host
Term
What is transfusion ?
Definition
Specific case of transplantation, using blood
Term
What is graft rejection ?
Definition
Graft is considered foreign and host's immune system tries to eliminate this "intruder" graft
Term
What is responsible for graft rejection for vascularized and non-vascularized skin grafts ?
Definition
Genetic differences at the MHC
Term
Can MIH (minor histocompatibility proteins) induce graft rejection ?
Definition
Yes
Term
Successful organ transplantation depends on what two things ?
Definition
Suitable MHC matching and life long non-specific immunosuppressive therapy
Term
Grafts are classified according to ?
Definition
Source of tissue donor
Term
Isografts are what ?
Definition
Grafts b/w identical twins
Term
Skin graft in the same individual is an example of what type of graft ?
Definition
Autografts
Term
Grafts b/w members of the same species ?
Definition
Allografts
Term
Grafts across species are called ?
Definition
Xenografts
Term
Which two grafts do not require immunosuppression ?
Definition
Autografts and isografts
Term
What is a graft b/w members of the same species called ?
Definition
Allograft
Term
Graft survival is a function of what two things ?
Definition
Degree of genetic similarity b/w individuals and immunosuppressive trt used
Term
3 advantages to xenograft transplantation ?
Definition
1) Relatively unlimited supply of organs
2) Genetic and pathogen-controlled source of material
3) Ability to plan for transp. so that recipient's health is optimal prior to surgery
Term
What causes hyperacute rejection ?
Definition
Occurs in minutes to hours post-transp.
Due to preformed Abs to donor antigens
Term
Trt for hyperacute rejection ?
Definition
Graft removal
Term
Hyperacute rejection is associated with what immunological processes ?
Definition
Complement activation
Stimulation of the coagulation cascade
Thrombosis
Rapid graft failure
Term
What is acute rejection ?
Definition
Most common type of allograft rejection
Occurs in weeks post-transp.
Due to recognition and activation of naive T cells
Trt is increasing dose of immunosuppressive agents
Term
Trt for acute rejection ?
Definition
Trt is increasing dose of immunosuppressive agents
Term
What is second set rejection ?
Definition
B/c memory T cells are generated as a result of engraftment, rejection of a second graft from the same donor results in accelerated rejection
Term
What is chronic rejection ?
Definition
Rejection occurring weeks/months/years following transp.
Is correlated with release of non-specific "growth-factor"-like mediators (ex: fibroblast growth factor, endothelial growth factor)
Less amenable for trt
Term
MHC = ?
Definition
HLA
Term
HLA = ?
Definition
MHC
Term
3 gene products of class 1 MHC gene loci are ?
Definition
HLA-A
HLA-B
HLA-C
Term
3 gene products of class 1 MHC gene loci are ?
Definition
HLA-DP
HLA-DQ
HLA-DR
Term
Genetic differences at any HLA locus contribute to ?
Definition
The immunological rejection of a graft
Term
MiH (Minor Histocompatibility Loci) encode proteins that serve what ?
Definition
Unknown function in a tissue
Term
What matching is the ideal scenario for clinical transplantation ?
Definition
Total histocompatibility matching (0/6 haplotype mismatches)
Term
3 methods for tissue typing to measure histocompatibility b/w donor and recipient are what ?
Definition
Serological
Mixed lymphocyte rxns
Molecular techniques
Term
What leads to the most vigorous rejection of grafts ?
Definition
Genetic differences at the class 2 MHC loci b/w the donor and recipient
Term
What cytokine stimulates monocytes, macrophages, and NK cells ?
Definition
IFNgamma
Term
What cytokine is a growth and differentiation factor for CD8+ pCTL cells?
Definition
IL-2
Term
What cytokine stimulates the differentiation of CD4+ T cells to Type 1 secreting cells that also secrete IFNgamma ?
Definition
IL-12
Term
What molecules slow down circulating leukocytes, causing them to roll on the endothelium present at the site of inflammation ?
Definition
Selectins
Term
What molecules induce strong adhesion b/w the leukocyte and the vascular endothelium ?
Definition
Integrins
Term
What enzymes disrupt the integrity of the basement membrane resulting in extravasation of leukocytes from the circulation into the graft bed ?
Definition
Metalloproteinases
Term
Preformed ABs to allografts exist in what two groups of people ?
Definition
Multiparous women
In individuals who have rejected a first organ draft
Term
The predominant xenoantibody reactivity is one directed against the what linkage of porcine carbohydrate antigens ?
Definition
alpha 1,3 galactosyl linkage
Term
What transplants occur in immunologically priveleged sites and survive w/o immunosuppressive drugs ?
Definition
Corneal transplants
Term
What is one problem with heart transplants ?
Definition
High incidence of atherosclerotic disease in recipients (including within the donor heart)
Term
Liver transplants are resistant to rejection when ?
Definition
When any early acute rejection episodes pass
Term
Is immune rejection a problem in bone transplants ?
Definition
No, because bone grafts are avascular
Term
Bone marrow transplants are used to treat what 3 things ?
Definition
Anemias
Leukemias
Lymphomas
Term
Graft versus host disease is a problem in what types of transplants ?
Definition
Bone marrow transplants
Intestine transplants
Liver transplants
Term
What happens in graft versus host disease ?
Definition
Donor T cells present in the graft initiate rejection of all host tissue
Term
Symptoms of graft versus host disease ?
Definition
Skin sloughing, diarrhea, inflammation of the lungs, liver, and kidneys
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