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13 Cards in this Set

  • Front
  • Back
When/what were the first immunosupressive drugs discovered?
1959, 6 metacaptopurine and azathioprine.
What is rejection; hyperacute?
Minutes/hours due to preformed Ig (pregnancy, transfusion). Facilitated by complement or platelet adherence to donor endothelium.
What is rejection; acute?
Days/weeks due to cellular (B/T/macrophage) response.
What is rejection; chronic?
Months/years due to a 'grumbling' response (that is largely idiopathic.)
True or false: Cadaveric transplants are better than live.
FALSE: living is better.
Name one of the two types of cadaveric organ. (1)
Heart beating; brain stem death.
Name the five components of a test for brain stem death.
Fixed pupils, corneal reflex, absent ocular-vestibular reflex, no response to supraorbital pressure and no cough response to bronchial stimulation.
Name one of the two types of cadaveric organ. (2)
Non-heart beating. There will only be a few minutes to save the heart before ischaemia and system wide clotting kick in.
What is a better: spousal or parental donor?
Spousal. Sonewhat counterintuitive but this is to do with age not HLA/tissue matching.
What are the risks of transplantation (three)?
Infection (both viral - CMV - and bacterial), malignancy (commonly skin - melanom is the most common cancer post transplantation) and side effects of immunosuppression.
How is ABO incompatibility overcome?
Pretransplant plasmapheresis + recipient immunosuppression to decrease preformed Ig resulting in desensitisation of a cross-matched positive transplantation.
What is accomodation?
Normal graft function in face of anti-donor Ig without signs of rejection.
What are the implications of achieving wide spread tolerance?
Removal of need for immunosuppression. No drug related side effects or chronic rejection. Impact on organ shortage and indefinite graft survival.