Transplantation Immunology (Hillebrands, Sanders, Kroesen)
27 important questions on Transplantation Immunology (Hillebrands, Sanders, Kroesen)
The location of a graft can be orthotopic or heterotopic. What is the difference?
Heterotopic means that graft is not placed in its "original" place. For example a kidney transplantation where the dysfunctional kidney is left in the recipient.
What is the difference between a autograft, isograft/syngeneic graft, allograft, and xenograft?
Isograft -> between genetically identical individuals, for example monozygotic twins
allograft -> between different member of the same species
xenograft -> between two different species, for examples human and pig
Why was the first kidney transplantation in 1954 a succes?
- Higher grades + faster learning
- Never study anything twice
- 100% sure, 100% understanding
For my 1st exam I got a C. Then, I started looking for ways to learn better and I came across Study Smart. Since then I have scored a A+, A, A- and another A. I highly recommend it to everyone who wants to hear it. I am so happy with it!!
I was struggling to finish all my first-year subjects for 3 years. Then I discovered Study Smart, which helped me to finish all of them within 3 months.
Because of StudySmart, things are going well in many ways. Before, I always had study stress and no time for anything. Now I feel calm and confident (because of the program). I used to score a B, now I usually score an A or A+.
Hey Chris, I really want to thank you very much for developing the platform, I usually got around C for my exams, now I scored an A+, an A and a A- !!
Since using Study Smart, my average has increased significantly. I even completed a statistics course with a A+ while I'm bad at statistics. I took on extra courses this year, because of Study Smart. Thanks so much!
Ever since I started studying with StudySmart I passed all my exams !!! No more re-sits!! At first, I was happy with a pass and now I only get good grades. Many thanks!
I aced all the courses I studied with Study Smart. For law, I first scored a D, and now an A! I’m 100% sure that I’ll pass all the courses I study with Study Smart.
I always thought I studied well. My grades were fine. I could never have imagined that applying these study skills would have such a huge and direct impact on my grades, my speed and the pleasure I have in learning.
For the first time, I finally feel totally confident about the way I learn. I have the perfect overview and make great progress in terms of speed and the grades I get. Thanks, Chris!
I immediately started to enjoy learning again, and my grades soared. All of a sudden, everything went better. I highly recommend Study Smart to all students..
Being able to create my materials online made the process of studying so much smoother and quicker. I no longer have to spend a huge amount of my time on creating my summaries.
At first, my notes were a mess. Now I use Study Smart to take my notes in a perfectly structured way. It helps me to save a lot of time and do other things I enjoy.
Students that study with Study Smart get better grades. The system applies all the learning methods in such a way that both well-performing students and students who struggle perform much better.
Hi Chris, I would like to thank you very much. Last year I scored C on a course, and this year I got an A+ thanks to your method! Thank you very much!
The largest effect is that my child is more enthusiastic about school! Every parent wants their children to be happy at school, Study Smart made it happen.
In high school, I failed several exams, and that has really changed now. I actually needed this tool very much back then. Since I started studying with StudySmart, I haven't had any D's. My average score is now an A and those are results I would have never had in the past
With my old method, I passed only 3 out of 8 courses. Since I started taking my notes digitally in Study Smart, I have passed all my courses on the first try. For me, StudySmart takes away the stress of wondering if I will pass or not.
Thanks to StudySmart, I passed all my exams, and with better grades than before! On top of that, I have mastered a very good study method now, which I am confident will help me earn my degree.
Name four challenges of solid organ transplantation
- Donor shortage
- Donor organ preservation
- Graft rejection
Is graft rejection mediated by the adaptive or innate immune system? And by which cell is this primarily mediated?
Primarily T cell-mediated.
Based on MHC polymorphic genes, which grafts are rejected?
Graft from F1 hybrid is rejected by parental strain. (So MHCaxb rejects the graft from MHCa and MHCb)
An allo-response is an extremely strong response (responding T-cell: 1-10% vs 0.001-0.0001%) Why do so many T cells respond to allo-MHC?
- no negative selection of T cells with affinity for allo-MHC (in contrast with self-MHC)
- higher density of alloantigens of allogeneic APC
- self peptides presented in allo MHC will also be recognized
- alloresponse is mediated (in part) by expanded clones of (memory) T cells
What happens during direct recognition of allo-MHC by T cells?
T cell (both CD4+ (classII) and CD8+ (classI) recognized unprocessed allogeneic MHC molecule on graft APC.
NO NEED HOST APCs!!
What are the different outcomes of direct and indirect recognition of alloMHC?
Indirect alloantigen recognition leads to:
- antibody-mediated injury to graft cells
- inflammation-mediated injury to graft
What happens during indirect recognition of alloMHC by T cells?
2) Self APC present the allo-MHC bound to self MHC molecule.
3) Alloreactive T cell reacts (CD8+)
What are the basic steps from sensitation to graft rejection?
2) Activation of T cells, generation of effector T cells by direct and indirect presentation
3) Migration of effector T cells to allograft
4) Killing of graft tissue cells and cytokine secretion lead to graft rejection.
What are the characteristic of hyperacute rejection?
- Pre-existing antibodies against endothelial antigens (for example bloodgroup antigens(carbohydrates), MHC and mHC antigens (proteins) and xeno-antigens.
leads to complement activation -> thrombosis, endothelial damage, inflammation -> occlusion
Acute rejection is a cell- and/or antibody-mediated response that occurs days/weeks after transplantation.
Describe the characteristics of acute cellular rejection.
A parenchymal infiltrate of CD4+ T cells (Th1, Th17) and CD8+ CTL causes recruitment of inflammatory cells (macrophages and neutrophils) and lysis.
-Parenchymal cell damage, interstitial inflammation.
Acute rejection is a cell- and/or antibody-mediated response that occurs days/weeks after transplantation.
Describe the characteristics of acute antibody-mediated rejection.
Antibody binding to endothelium --> complement activation --> lysis and thrombus formation
Antibody binding to Fc-R on neutrophils and NK cells --> lysis endothelial cells.
- Endotheliitis
What are the characteristics of chronic graft rejection?
- Multi factorial process (CD4+ T cells, cytokines, macrophages)
- Chronic inflammatory reaction in vessel wall --> fibrosis and transplant vasculopathy (graft arteriosclerosis) caused by the proliferation of vascular smooth muscle cells (VSMC)
How can graft rejection be prevented and treated?
- Preserving donor organ quality
- Suppression of the immune system (immunosuppressive drugs)
The graft survival rates after use of Cyclosporine showed a positive effect. What is the immunosuppressive mechanism behind this?
What are other mechanisms of immunosuppressive medicine on T cells besides cyclosporine?
- killing of proliferating cells (antimetabolites)
- depletion of T cells
- costimulatory blockade (B7)
How can B cell activity be suppressed?
- plasmapheresis
What is the "dark side" of immunosuppression?
- B cell-derived lymphomas
- diabetes, hypertension
- cardiovascular disease
- nephrotoxicity
Who can donate organs?
- non heart beating donors
- living donors
Organ survival is determined by:
- presence of HLA-antibodies in the recipient
- immunosuppressive medication
From what events are HLA-antibodies formed?
- bloodtransfusion
- pregnancy
- previous transplantations
HLA-typing is the combination of all HLA-molecules expressed by an individual. There are alleles in HLA-class I and HLA-class II,
which are they? And what is the maximal possibility of different HLA-molecules?
HLA-class II: DR, DP, DQ: maximal 6 HLA alleles
total: maximal possibilities: 12 different HLA-molecules
What HLA linkage disequilibrium is the strongest between which alleles?
DR- and DQ-locus
What are two forms of analysis of HLA-antibodies?
= incubation of patient-serum with lymphocytes of a selected panel of individuals. least sensitive but clinically most relevant.
- luminex single antigen assay (LSA)
= incubation of patient serum with beads, coated with specific HLA-molecules. highly sensitive and discriminative between specific HLA-molecules.
Which HLA polymorphism is on a higher level, genetic or protein?
Try our study magic for free
a PDF, study it super fast
- No sign up, email or credit card needed!
- AI makes unlimited flashcards
- Get unlimited quizzes and tests
- Ask AI anything
- No sign up, email or credit card needed!
- Have and keep perfect overview
- Make flashcards, notes and mind maps
- Review, test and score!
The question on the page originate from the summary of the following study material:
- A unique study and practice tool
- Never study anything twice again
- Get the grades you hope for
- 100% sure, 100% understanding
