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Dennis Serrano
Liver 65-75 +/- - - 18-24 hrs. cascade of immune reactions. Most immunosuppressive
Lung 50 + - +/- 6 hrs. drugs used to prevent rejection target the Th.
Heart 55-60 + - +/- 6 hrs.
*+, criterion; -, not a criterion
PART 2.
Classification of Rejection
1. Hyperacute
Histocompatibility
• In patients with pre-formed cytotoxic Ab
• Mutual tolerance between tissues that allows them to
• Within minutes to hours after transplant
be grafted effectively.
• In recent years, this has been prevented through
Pre-transplant Histocompatibility Testing pre-transplant tissue cross-matching
Blood Typing 2. Accelerated
• ABO Blood Group • Within days to weeks (~2-3 days)
Tissue Typing • Flu-like symptoms
• Major Histocompatibility Complex (MHC) Antigens
• Humoral and cellular components
• Glycoproteins on cell membranes
• Doesn’t respond to anti-rejection treatment
• Encoded by MHC genes in short arm of Chr 6 3. Acute
• 2 Classes: • With flu-like symptoms as well
o Class I: HLA-A, HLA-B, HLA-C
• Myalgia, malaise, fever, decrease in urine output,
o Class II: HLA-DP, HLA-DR, HLA-DQ
high creatinine, tender graft, HPN
Tissue Cross-matching
• Manifests weeks to months post-transplant
• Detects circulating PREFORMED cytotoxic antibodies
• There is graft swelling (local inflammation)
• Keyword here is PREFORMED • Tx: increase immunosuppression
o from previous blood transfusion 4. Chronic
o pregnancy (fetus is considered a foreign body)
• Gradual decline in kidney function
o from previous transplant (these patients are
• There is interstitial fibrosis
called “sensitized people”; their immune systems
• Continuous bombardment with focal inflammatory
have already been alerted before)
reactions slowly scars kidney tissue
Indirect Direct Allorecognition
• Manifests years after sugery
Allorecognition
Recipient Donor APC • Cannot be prevented (Kaya may lifespan ang
APC