Transplants and Amyloidosis Flashcards

1
Q

Explain the types of transplants:

1) allograft
2) autograft
3) isograft
4) xenograft

A

1) donor and recipient genetically different but same species
2) self to self
3) donor and recipient are identical twins
4) donor and recipient are from different species

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2
Q

What is the greatest barrier to a successful transplant?

A

rejection

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3
Q

What are the different types of rejection?

A

cell mediated- direct and indirect

humoral

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4
Q

Type of rejection due to activation of recipient CD4+ and CD8+ T cells by display of donor MHCs on recipient APCs?

A

Direct Cellular rejection

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5
Q

Type of rejection due to activation of CD4+ T cells leading to B cell production of Ab by display of donor antigens on recipient APCs?

A

Indirect Cellular rejection

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6
Q

What are the 3 types of antibodies that play a role in humoral rejection?

A

anti-ABO Ab
pre-formed anti-HLA Ab (from pregnancy/previous transplant/transfusion)
anti-HLA Ab formed post-transplant

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7
Q

What tests must be run before a donor can be matched with a recipient?

A

ABO typing
HLA typing
alloantibody testing
lymphocyte cross-match testing

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8
Q

What type of rejection is most likely to occur in a renal allograft transplant?

A

chronic

immunosuppression will prevent acute rejection

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9
Q

Describe the mechanism for acute renal allograft rejection

A

host macrophages and CD8+ cells are activated causing cell mediated hypersensitivity
and
host CD4+ cells get activated, and lead to Ab production in antibody mediated hypersensitivity
last days to weeks

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10
Q

What causes hyperacute renal allograft rejection?

A

anti-ABO and pre-formed anti-HLA Ab –> complement activation –> thrombi –> necrosis in minutes to hours

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11
Q

What is the mechanism for graft vs. host disease?

A

transplanted donor T cells recognize host cells as foreign

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12
Q

Define amyloidosis?

A

a group of disorders with deposition of amyloid protein in extra-cellular spaces in tissues/organs

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13
Q

What tests would you do to confirm an amyloidosis diagnosis?

A
tissue biopsy
HE stain (linear non-branching fibrils in beta sheets) Congo red stain (red) with green bi-refringence 
immunohistochemistry or liquid chromatography and mass spectrometry to determine the specific type
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14
Q

What proteins build up in primary or AL systemic amyloidosis?

A

Ig (lambda) light chains or amino-terminal fragments of light chains (Bence Jones proteins) secreted by monoclonal plasma cells

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15
Q

Build up of fragments of the serum amyloid associated (SAA) protein associated with HDL in combination with a chronic inflammatory disease would lead to what diagnosis?

A

AA or secondary systemic amyloidosis

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16
Q

What type of amyloid is most often associated with AD?

A

beta amyloid

17
Q

Build up of a serum protein that binds/transports thyroxine and retinol in heritable neuropathic/cardiomyopathic amyloidosis is due to what?

A

mutation in the gene for TTR (transthyretin)

18
Q

What type of amyloidosis is primarily associated with long term dialysis?

A

beta 2 microglobulin

19
Q

Genetic mutation 11e122 causes what?

A

late onset cardiac amyloidosis with restrictive cardiomyopathy and arrhythmia

20
Q

What are the most common organs to be affected by amyloidosis?

A

kidney
heart
liver