Solid Organ Transplant Rejection
- Created by: MazzaW
- Created on: 13-11-19 14:07
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- Organ rejection
- Hyperacute
- Preformed antibodies
- Non-ABO matched organs
- Minutes-hours
- Non-HLA matched
- Ab reacts with Ag on vascular endothelium
- Activates coagulation and complement cascades
- Vessels become blocked
- Organ death
- Vessels become blocked
- Activates coagulation and complement cascades
- Acute
- Acute cellular
- T-cell mediated
- Infiltrate organ causing dysfunction
- Few days to 1-2 weeks
- T-cell mediated
- Acute humoral
- Antibody mediated
- Few days to weeks
- Becoming more common
- Better detection
- Good anti-T-cell drugs
- Acute cellular
- Chronic
- Months to years
- Secondary to endothelial damage
- AlloAbs
- Immune complex deposition
- Complement activation
- Macrophages
- Fibrosis
- Infiltrative
- Concentric arterial sclerosis
- Associated with ischaemia- reperfusion injury
- Leads to chronic inflammation and scarring
- Prevention
- ABO and HLA matching
- Immune suppression
- Serotherapy
- Anti-thymocyte globulin
- Prednisolone
- Risk of Cushing's syndrome
- Calcineurin inhibitors
- Cyclosporine
- Tacrolimus
- mTor inhibitors
- Sirolimus
- Anti-proliferatives
- Azathioprine
- Mycophenolate
- Too much immune suppression
- Infection
- B lympho-proliferative disease
- Serotherapy
- Hyperacute
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