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tissue transplant from the same individual


transplant from a genetically identical individual


graft from a non genetically identical individual


graft from another species

rejection occurs in

Allograft and xenograft

Hyperacute rejection

rapid vascular occlusion within mins
intravascular clotting and thrombosis
not reversible
Class II MHC starts to be expressed, can be caused by blood group antigens
A TYPE 2 hypersensitivity, but looks like 3

Acute Graft Rejection

Days to years later
Acute cellular rejection (Necrosis, mild intestinal hemorrhage)
Mediated by CTL- lysis, DTH, Responsive to Cyclosporine
Antibodies may be inolved
complement activated
Necrotizing Vasculitis

Chronic Rejections

Months to years
Slow rise in creatine levels
intestinal fibrosis
Tubular atrophy in renal system
Ultimately results in Ischemia and loss of function

Graft vs host disease

occurs in bone marrow transplants, where the transplanted T-cells attack the recipients tissues


Prevents graft rejection
treats Graft Vs host
certain autoimmune disorders
dermatological disorders
sometimes used with corticosteroids
BLOCKS signaling for IL-2 Transription
Numerous Toxicities though


Similar MOA as Cyclosporin (Blocks IL-2)
binds to FK binding protein to block calcineurin
lots of toxicities
same indications as cyclosporine


Binds to immunophilins and inhibits calcineurin
Does not block IL-2
Blocks T-cell response to Cytokines
Blocks B cell proliferation
Can be used with other immunosuppressives
Use similar to cyclosporin
Toxic like the others (profound myelosuppresion)

Mycophenolate Mofetil

Inhibits B and T cell proliferation
Inhibits de novo sythesis of purines
Used for refractory solid organ transplants
can treat lupus nephritis, RA and some derm. disorders


Reduces size of lymphoid content of lymph nodes and spleen
messes up cell cylce of activated lymphoid cells
Inhibits IL-1 (IL-3 - IL5, IL-8 and TNF-a)
Multiple indications
Multiple toxicities including bone mineral loss

Other treatments

antibodies specific for CD3, IL-2R, and CD40L

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