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15 terms

Transplantation

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Autograph
tissue transplant from the same individual
Isograph
transplant from a genetically identical individual
Allograft
graft from a non genetically identical individual
Xenograft
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
Cyclosporine
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
Tacrolimus
Similar MOA as Cyclosporin (Blocks IL-2)
binds to FK binding protein to block calcineurin
lots of toxicities
same indications as cyclosporine
Sirolimus
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
Gluccocorticoids
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