The different types of grafts

Autograft: tissue transferred from one part of the body to another within the same individual Isograft: tissue transferred between genetically identical individuals Allograft: tissue transferred between genetically different individuals of the same species Xenograft: tissue transferred between individuals of different species

Histocompatibility Tissues that are antigenically similar said to be histocompatible. Such tissues do not induce an immunologic response that leads to tissue rejection. Histoincompatibility Tissues that display significant antigenic differences are histoincompatible and induce immune responses that lead to tissue rejection.

What are the antigens that cause rejection?

Red blood cell compatability. MHC compatability In humans this complex is called the human leukocyte antigen (HLA) complex. In mice it is called the H-2 complex.

Mechanism of graft rejection

There are two phases to cell mediated

graft rejection
sensitization stage effector stage

Sensitization
Both CD4+ and CD8+ cells recognize alloantigens on the surface of grafted cells and proliferate in response There are two ways of presenting alloantigens on the transplant to the recipients T cells Direct allorecognition-mhc donor Indirect allorecognition-peptida donor

Effector Stage
A variety of effector mechanisms participate in allograft rejection The most common are cell-mediated reactions involving Delay Type Hypersensitifity and CTL mediated cytotoxicity; less common mechanisms are antibody plus complement mediated lysis and ADCC

Clinical manifestation of graft rejection

The time course of graft rejection varies depending on They type of tissue or organ grafted. The immune response involved Types of allograft rejection: - Hyperacute rejection - Acute rejection - Chronic rejection

Hyperacute Rejection
Rapid: occurs in minutes to days Mediated by preformed antibodies and complement No treatment Prevention

Acute Rejection
Most common Occurs days to months post-transplant Cell-mediated immune response Treated by increasing the net-jaringan state of immunosuppression

Chronic Rejection
Progressive decline in allograft function Presents differently in each organ transplant type Occurs months to years post-transplant Therapy: prevent vs. delay the inevitable?

General immunosuppressive therapy

Mitotic inhibitors Corticosteroids. Total lymphoid irradiation CyclosporinA, FK506, and rapamycin