Beruflich Dokumente
Kultur Dokumente
Faculty of
.medicine
Alexandria
.university
Graft
Department of
.pathology
rejection
:0bjectives
.Introduction.1
.Types of transplantation.2
.Graft rejection.3
.Causes of graft rejection.4
.Mechanism of graft rejection.5
.Types of graft rejection .6
.Treatment of graft rejection.7
: Transplantation
Transferring cells, tissues, or organs
from one site to another
Types of
:transplantation
.Autologous graft = auto graft
.Synegenic graft = syngraft
.Allogeneic graft = allograft
.Xenogenic graft = xenogaft
:Graft rejection
Occurs when a transplanted organ or tissue
fails to be accepted by the body of the
.transplant recipient
Causes of
:graft rejection
Pleomorphism of MHC genes
Graft failure
echanism of graft rejectio
)T Cell Mediated )Ce
.Dire
.Indire
inflammation
.Lysis of grafted tissue
mononuclear cells
:Types of T cell mediated reaction
1. Direct Pathway:
T cells of recipient recognize allogenic MHC molecule
on the surface of an APC in donor.
interstitial dendritic cells of donor organs are the best
immunogenic.(why?)
CD4+ and CD8+ T cells of recipient encounter antigens
in lymph nodes
CD4+ proliferate, release cytokines& trigger delayed
hypersensitivity reaction.
Cytokines vascularity &induceinflammation.
mature CTLs are generated and lyse grafted tissue .
:Indirect pathway .2
recipient T lymphocytes recognize antigens
after being presented by own antigen-
presenting cells.
same as presentation of microbial antigens.
2.Antibody Mediated Reactions :
)Humoral rejection(
1. In Hyperacute reaction:
previous exposure to the donor antigens.
As in:
previous rejected kidney transplant.
Multiparous women.
Previous blood transfusion.
2. In chronic rejection:
not previously exposed to the donor antigen.
Abs cause damage by complement, ADCC &Ag Ab
complex
Types of graft
:rejection
.a) Hyper acute = immediate
.b) Acute = cellular
.c) Chronic = fibrosis
Hyper acute
:rejection
Reaction : due to
complement + preexisting antibodies as
( (ABO) (humoral
:Time
.occurs within minutes to hours
:Complication
.Rapid thrombosis, no vascularization
.Infarcts
. Acute systemic inflammation
:Prognosis
.Organ is removed
:Steps involved
Morphology of hyper acute
In hyper acutely rejecting kidney
Grossly:
Not enough
.repeated.2
Not enough
.tripple therapy.3
:Triple therapy
.Corticosteroids e.g Cyclosporin A.1
.Calcineurin inhibitor.2
. Antiproliferative agent.3
:plus
.antibodies against blood vessels
blood transfusion remove antibodies&
. against the transplant
Graft associated immune
:suppression
:corticosteroids.1
.lyse mature T cells
Dnase +
cytokine synthesis
IL1, IL6& TNF
:Metabolic toxins.1
.lymphocyte growth
:as
Azathioprine
Cyclophosphamide
Cyclosporin
Calcineurin
:Irradiation.2
:Induce tolerence.4
.by multiple blood transfusion
:Antibodies.5
.against T cell surface proteins
.monoclonal Ab against CD3
.antibodies against b cells
Can also remove Ab by plasmapheresis
Thank
..…you