Kidney Transplant Immunology Flashcards

1
Q

What happens with antibody production in kidney transplantaion

A

Very early graft loss - 48 hours - hyperacute rejection
Preformed antibodies present in 1% of the population
Activation of clotting and complement leading to intravascular thrombosis, ischemia, and subsequent necrosis

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2
Q

What is the solution for antibody producition

A

transplant cross-match or immunoadsorption
Cross-match: take cell from donor (usually spleen). Take sera from recipient. See whether lysis is present.
Immunoadsorption: makes blood go through column to adsorb antibodies

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3
Q

Describe MHCs in humans

A

Class I: A, B, C
Class II: DR, DQ, DP

Very polymorphic = high variability

MHC I: all cells except RBC
MHC II: only APCs

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4
Q

What are the effects of complement and clotting facotrs

A

Occlusion of the blood supply to an organ induces ischemia reperfusion injury (tissue damage caused when blood supply returns to tissue after a period of ischemia. Absence of oxygen and nutrients creates a condition in which the restoration of circulation results in inflammation and oxidative damage through the induction of oxidative stress). Activation of the complement and clotting systems: damage and also increased immunogenicity (ability to induce a humoral or cell-mediated immune responses).
Ex ‘vivo’ normothermic perfusion now standard for renal transplant - restores circulation and allows an organ to regain function prior to transplantation.

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5
Q

What is allorecognition

A

T cells in the periphery recognise peptide derived from pathogens and transformed cells in the context of self-MHC; however, they can recognise donor MHC molecules.

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6
Q

What do MHC incompatible cells do

A

Induce uniquely strong immune responses. Reflects the uniquely high precursor frequencies of T cells with direct anti-MHC allospecificity.

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7
Q

What do DCs do

A

link between the innate and adaptive immune systems.
Present mainly in tissues exposed to the external environment (immature-antigen capture)
Most potent APCs (mature)
Normally activated by TLRs
DCs are transplanted with graft. Foreign DCs are activated due to complement and clotting factors.

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