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Tissue typing

?What is tissue typing


Name give to test which identify an individual HLA (we do test called HLA for -
(individual
There is no compatible 100% except in twins -
if also mean ,in vitro identification of surface Ags & antigenic character of -
(lymphocyte (HLA
It controlled by genetic determinants by what called MHC genes -
situated in short arm of chromosome #6 -

Test for compatibility


HLA (HLA-A, HLA-B & HLA-DR) and ABO
Screening for presence of preformed to allergenic HLA

Test for pathogen


.(Human immunodeficiency disease (HIV-1\2
.(Hepatitis B (Hbs Ag
.(Hepatitis C (HCV
.Also CMV, HTLV-1, Syphilis, Epstein-bare virus and HTLV-2

TISSUE Typing
1. Micro cytotoxicity assay
2. Mixed lymphocyte culture (MLC)
3. Flow cyto cross typing
4. DNA analysis (genomic typing )

How we do tissue typing?

Tissue typing (HLA-detection) could be done by:


1. Serological technique.
I.e : Lymphocyte caytotoxicity ,cross maching & Abs detection

2. Cellular interaction technique.


Mixed lymphocyte culture (MLC)

3. Moléculaire (DNA)genetic technique.


PCR

FLOW CHART OF HLA TESTING FOR


THE RENAL TRNASPLANTATION

PREFORM IMMUNOLOGICAL EVALUATION:

1-for patient
- HLA typing
- ABO typing
-Screening of serum for Abs reactive to donar HLA Ags
-Testing of serum for Auto-Abs
2-living related donor
- HLA typing
- Rh\ ABO typing
- cross matuing with patient serum to detect anti-donor Ab

Organ matching criteria:  ‫ماقدرت اكتبه‬


1-
2-
3-
4-

Types (major form) of grafting (‫) مهم‬


1- Auto graft
(from the patient it self but anther part )

2- Isograft
(between same identical twins )

3- Allograft
(homograft genetically different of the same species most
Common form organ )

4-xenograft
(from animal to human, baboon heart to infant, always rejecting, intense immune
response, very difficult to suppressor

Grafting : process of take cell , tissue or organ from one individual and placing
into another , it was discovered by marrium Webster.

Note :
- it also means implantation of non self tissue in body
- transplantation is 3rd area of immunopathology
- the first transplantation was in 1682

who can be an organ tissue donor ?


1- brain stem dead patient on machine
2- no heart breathing donation

definition of death
- irreversible loss of capacity for consciousness and breath
- cardio respiratory death
- brain stem death

Mechanism of graft rejection


It's phenomena of graft rejection between unrelated or un compatible
individual(allergenic) by immune response mainly by cytotoicity

Two stage : frist rejection : sensitization stage


2- second : rejection effectors (memory) stage
Rejection
immune system detects foreign tissue and fights it by cellular & humeral immune
response mainly by cytotoicity

Host versus graft rejection (HVGR)

1- hyperacute rejection (few hr or in first day )


antibody to HLA and ABO (if patient was sensitize )

2-acute rejection method


By T-cell (day or week )

3-chronic rejection (meny day)

Classification of rejection:

1-host Vs graft rejection (donor faight against implanted organ)


Compatible organ transplantation

2-graft Vs host rejection ( implanted oran faight against donor body)


as : bonemarow or immune cell transplantation

the mechanism of tissue rejection include (‫)مهم‬


1. role of T-lymphocyte (all T-cell type(Tc & Th) and it depend on CD4
& CD8)

2. antigen presenting cell (APC)


immunogensity against different tissue

3. effect of antibody
have role in HLC and complment will activate

4. graft factor (type of graft and site of graft )

my note : That mean the immune response against which is stronger i.e it more
strongly in bone marrow than the cornea

5. role of cytokine

strongly rejection according to dgree of antigenisty


:
1- bone marrow
2- skin
3- heart
4- kidney
clinical phases of kidney rejection of :
1- hyperacute rejection:
whiten minute and depend on presence or abcense of antibody

2- accelerated rejection:
whiten a few day (2-5day) depend on cell mediated & on presence or
abcense of antibody

3- acute rejection:
from (7-21 day) depend on cell mediated & on presence or abcense of
antibody

4- chronic rejection:
latter than 3 month by cell mediated

5- immunological rejection:
than latter than 3 month

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