Assoc. Prof. Ma. Jennifer R.

Tiburcio, MSMT Department of Med Tech

UST Faculty of Pharmacy

Grafting Transfer of cells One part of the body to another One individual to another Transferred material (graft)

bone marrow transplant Syngraft (Isograft) Allograft (Homograft) Most organ transplants: kidney. lungs.TERM Autograft SOURCE OF TISSUE Tissue is from the recipient Tissue from a genetically identical individual. etc. Xenograft (Heterograft) Material from an animal of a different species Baboon heart transplanted into a human . i. bone marrow transplants Kidney transplant. identical twin Tissue from a genetically distinct individual of the same species EXAMPLES Autologous skin grafting. heart.e.

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Homostatic – no occurrence of growth of the transplanted graft 2. Homovital – occurrence of tissue growth after transplantation . Orthotopic – same place 2.Physical Placement 1. Heterotropic – different site Growth Properties of graft 1.

Transplant Tissue  Most immunogenic Bone marrow Skin Islet of langerhans Heart .

Kidneys Liver Bone Xenogeneic valve replacement  Least immunogenic Cornea .

TYPE OF TISSUE Hyperacute TIME OF TISSUE DAMAGE W/in minutes MECHANISM CAUSE Humoral Accelerated 2 to 5 days Cellular Preformed cytotoxic antibodies to donor antigen Previous sensitization to donor antigen Acute 7 to 21 days Cellular (ADCC) Development of allogeneic rxn to donor antigen Disturbance of host/graft tolerance Immunopathologic Chronic Later than 3 months Later than 3 months Cellular Immunopathologic damage to the new organ 1. immune complex disorder 2. complex formation w/ mechanisms related to circumstances necessitating transplant .

Corneal Does not evoke rejection Tissue does not come in contact with the immunologic system Bone Provide mechanical function and support Ethylene oxide or gamma radiation .

Kidney ABO & HLA Cadaveric transplantation Number of mismatches is zero or one Liver. heart & Lungs Problem – difficulty in detecting rejection episodes .

Heart Transplanted within 4 hrs Prospective matching DNA typing Donors & recipients –ABO & size of the organs Pancreas Islet cells – life-enhancing ABO blood grouping Tissue crossmatching Matching of HLA-DR antignes .

Bone marrow HLA – more crucial Regenerate replacement marrow w/in 8 weeks High doses of chemotherapy or radiationto prevent rejection Destroy any residual cancer cells Provide space for the new marrow to grow .

Graft-versus-host (GVH disease)  Occurs when grafted immunocompetent cells from a donor mount an IR against the host tissues  Matching of the HLA-A & B and HLA-Dw  Use of methotrexate & cyclosporin has greatly reduced the occurrence of this phenomenon .

Host Reaction .Versus.Graft Reaction Graft.Versus.HOST RESPONSE TO TRANSPLANTATION   Host.

initiating an inflammatory response that leads to loss of graft function.In Organ Transplantation: foreign HLA molecules of the graft serve as ligands (targets) for T cell receptors in the recipient. = GRAFT REJECTION .

Versus.Graft.Host Reaction .

Graft.Versus.Host Reaction  Common manifestations: – Diarrhea – Erythema – Weight loss – Malaise – Fever – Joint pains – Death .

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Lymphocytotoxicity Test  Used for the serological detection of MHC class 1 & class II antigens.  If the patient’s serum is cytotoxic or the donor’s cells the transplant is not performed.  Once a donor has been selected. . the match is confirmed by using donor’s cell &recipients serum in a repeat lymphocytotoxicity test.

Patients lymphocytes incubate Reagent Antibody Add C’ incubate c Tryptan bluedye c Dead cells take up dye= positive for that HLA antigen + C’ Live cells take up no dye= Negative for that HLA Ag .

Mixed leukocyte reaction  Detects the degree of immune cellular stimulation of the recipient’s T lymphocytes by donor cells. .

DonorLymphoctes + Recipients lymphocytes Tritiated Day 5 Count radioactivity in cells Lymphocyte are isolated from the whole blood of both the donor & the recipient using Ficoll-Hypaque centrifugation. .The lymphocytes are incubated together at 37degrees Celsius for 5 days.

Immunosuppressive Treatments Antigen Non-specific Drugs: Azathioprine Steroids Cyclosporine Anti-lymphocyte globulin Radiation .

 Antigen specific Neonatal tolerization Enhancing (anti-allogeneic) antibodies Anti-idiotype antibodies to receptors on T cell Blood transfusion in human kidney transplant .

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