Solid Organ Transplant Rejection

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  • 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
    • Acute
      • Acute cellular
        • T-cell mediated
          • Infiltrate organ causing dysfunction
        • Few days to 1-2 weeks
      • Acute humoral
        • Antibody mediated
        • Few days to weeks
        • Becoming more common
          • Better detection
          • Good anti-T-cell drugs
    • 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

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