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TRANSPLANTATION IMMUNOLOGY
1. PRESENTED TO :
PROF.(DR.) ASHA KHANNA
DEPARTMENT OF BIO-SCIENCE
PRESENTED BY :
ATUL PATEL
MSc. 2nd SEM MICROBIOLOGY
2. TRANSPLANTATION
Transplantation is the process of moving cells,
tissues, or organs, from one site to another,
either within the same person or between a
donor and a recipient.
If an organ system fails, or becomes damaged
as a consequence of disease or injury, it can
be replaced with a healthy organ or tissue
from a donor.
3. • Alexis Carrel- study of transplantation in 1908; he
interchanged both kidneys in a series of nine cats. cats
maintained urinary output for up to 25 days. Although all
the cats eventually died.
• The first human kidney transplant, attempted
in 1935 by a Russian surgeon, failed because there was a
mismatch of blood types between donor and recipient.
• The first successful human kidney transplant, which was
between identical twins, was accomplished in Boston in
1954.
5. Autograft :-
Transplantation of cells, tissues or organs between sites
within the same individual e.g. skin graft.
Isograft:-
Isograft is tissue transferred between genetically identical
individuals. This occurs in inbred strains of mice or
identical human twins.
Allograft :-
Transplantation of organs or tissues from a donor to a non-
genetically identical individual of the
same species. Allografts are the most common type
of transplant.
6. Xenograft:-
It is the tissue transferred between different species. This
graft is also normally rejected. Pigs’ hearth valve usually
transplanted to humans.
ABO incompatible
ABO refers to blood group, which can vary between
individuals. For most transplant types, matching of blood
group between donor and recipient is a key strategy in
reducing rejection risk.
Stem cell transplant
Stem cells are cells that have the capacity to develop into a
range of different types of cells in the body.
11. Clinical stages of rejection
Hyperacute rejection
This occurs within minutes or hours after a transplantation
and is caused by the presence of pre-existing antibodies of
the recipient, that match the foreign antigens of the donor,
triggering an immune response against the transplant.
Acute rejection
This occurs within the first 6 months after transplantation.
Some degree of acute rejection will occur in all
transplantations, except between identical twins.
Chronic rejection
Repeated episodes of acute rejection can ultimately lead to
chronic rejection of the graft and failure of the transplant.
13. Factors favoring allograft
survival(Rejection
Prevention)
HLA typing of potential donors
and a recipient can be
accomplished with a
microcytotoxicity test. In this
test, white blood cells from
the potential donors and
recipient are distributed into a
series of wells on a microtiter
plate, and then antibodies
specific for various class I and
class II MHC alleles are added
to different wells. After
incubation, complement is
added to the wells, and
cytotoxicity is assessed by the
uptake or exclusion of various
dyes (e.g., trypan blue or
eosin Y) by the cells.
Reference :kuby immunology
14. Finding an eligible donor-recipient match:-
Rejection can be minimized by carefully matching the
donor and recipient for compatibility prior to
transplantation.
Compatibility between donor and recipient is assessed
using a combination of tests, including:
• ABO blood group compatibility
• Tissue typing
• Cross matching
• Panel reactive antibody test
• Serology screening
15. General Immunosuppressive
Therapy
To reduce the risk of transplant rejection, patients are treated
with immunosuppressive drugs that will dampen their immune
response.
• Mitotic Inhibitors Thwart T-Cell Proliferation –
Azathioprine (Imuran), a potent mitotic inhibitor, is often
given just before and after transplantation to diminish T-cell
proliferation in response to the alloantigen's of the graft.
• Corticosteroids Suppress Inflammation
corticosteroids, such as prednisone and dexamethasone, are
potent anti-inflammatory agents. It prevent acute episodes of
graft rejection.
• Certain Fungal Metabolites Are Immunosuppressant
Cyclosporin A (CsA), FK506 (tacrolimus), and rapamycin
(sirolimus) are fungal metabolites with immunosuppressive
properties.
16. Clinical Transplantation
Since the first kidney transplant was performed in the 1950s,
approximately 400,000 kidneys have been transplanted worldwide.
The next most frequently transplanted solid organ is the liver
(52,000), followed by the heart (42,000) and, more distantly, by the
lung (6,000) and pancreas (2,000). Bone-marrow transplants
number around 80,000.
The frequency with which a given organ or
tissue is transplanted depends on a number of factors:
• Clinical situations in which transplantation is indicated.
• Availability of tissue or organs.
• Difficulty in performing transplantation and caring for
post-transplantation patients.
• Specific factors that aid or hinder acceptance of the
particular transplant.
