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Transplant 2
Surgery 2
| Question | Answer |
|---|---|
| a molecule that can interact with the immune system | antigen |
| peptides produced by B lymphocytes that attach to foreign material and aid in removing it from the body | antibody |
| cells that display foreign antigen complexed with MHC on its surface. | antigen presenting cell |
| these genes are expressed on the surface of cells in all jawed vertebrates, and display fragments of molecules from invading microbes or dysfunctional cells | major histocompatibility complex MHC |
| are encoded by the MHC genes | Human Leukocyte Antigens HLA |
| circulation peptides that influence behavior of the immune system (IL-2) | cytokines |
| a protein complex of T lymphocytes that can identify MHC molecules | T-Cell Receptor |
| interact with APC MHC II molecules via the TCR release cytokines (primarily IL-2) | CD4 lymphocyte |
| interact with MHC class I molcules (that contain foreign peptides) and can directly kill the foreign cell | CD8 T lymphocyte |
| of the same species | allogenic |
| a test for determining tissue compatibility between a transplant donor and the recipient before transplantation, in which the recipient's serum is tested for antibodies that may react with the lymphocytes or other cells of the donor | crossmatch |
| the preexisting antibodies against HLA antigens in the serum of a potential allograft recipient that reacts with a specific antigen in a panel of leukocytes, with a higher percentage indicating a higher risk of a positive crossmatch (listed as % antib) | panel reactive antibodies PRA |
| a state of immune acceptance without immunosuppression | tolerance |
| MHC I goes with __ | CD8 T cells (8/1=8) |
| MHC II goes with __ | CD4 T cells (8/2=4) |
| what are the 2 allogenic recognition pathways | direct and indirect |
| T-cells and their receptors identify allogeneic MHC molecules. This generates CD8 T cells which causes attack on an organ and therefore rejection | direct allogenic recognition pathway |
| antilymphocyte antibodies used to prevent rejection until maintenance suppression is therapeutic | induction immunosuppression |
| the important cytokine to remember from the transplant lecture | IL-2 |
| drugs that end in "-mab" are __ | monoclonal antibodies |
| when a transplanted organ is placed in its normal anatomic location in the recipient | orthograft |
| when a transplanted organ is placed in an area that is not its normal anatomic location in the recipient | heterograft |
| major cause of increased demand for organs | hepatitis C |
| antigen presenting cell APC | a cell that displays foreign antigen complesed with MHC on its surface, which is then recognized by t-cell receptors on T cells |
| major histocompatibility complex MHC | genes expressed on the surface of cells in all jawed vertebrates and display fragments of foreign molecules to T cells |
| define cross match | a test for determining tissue compatibility between a transplant donor and the recipient before transplantation, in which the recipient's serum is tested for antibodies that may react with the lymphocytes or other cells of the donor |
| which cytokine is responsible for the majority of immune cell activation | interleukin 2 IL-2 |
| immediate killing of a transplanted organ occuring in patients with preformed antibodies to the donor in the bloodstream | hyperacute rejection |
| rejection of the transplanted organ occurring between 5-90 days due to the infiltration of the recipient's immune system into the donor organ | acute rejection |
| chronic allograft vasculopathy due to development of atherosclerosis | chronic rejection |
| antilymphocyte antibodies used to prevent rejection during first few days after TP | induction immunosuppression |
| maintenance immunosuppression | long term therapy with two or three drugs |
| treatment of acute rejection | steroids and antilymphocyte preparations given over period of several days |
| most important side effect of cyclosporine | nephrotoxicity |
| most important complication of immunosuppression | opportunistic infection |
| how are donor organs transported | hypothermic storage with UW solution |
| why is the left kidney preferred in renal transplant | the renal vein is longer on the left side |
| what lab value is used to evaluate success of liver transplant | PT/INR |
| what lab value is used to evaluat the success of pancreatic transplant | glucose |
| 1-year survival rate following liver transplant | 85% |
| 1-year survival rate following heart transplant | 80% |
| 1-year survival rate following lung transplant | 70% |
| what imaging modality is used to evaluate liver and kidney anastomoses post-operatively | ultrasound |
| what consideration must be made regarding pancreas transplant | risk of diabetic complications vs complications of lifelong immunosuppression therapy |
| what clinical sign is associated with acute heart transplant rejection | tachycardia |
| approach to the patient 3 hours post renal transplant who stops making urine | flush foley cath, assess fluid status(give 500cc crystalloid LR or NS), ultrasound to assess renal artery/vein patency, return to OR |
| why must you be overly concerned for infectious processes in patients s/p organ transplant | immunosuppression therapy results in a blunted inflammatory response and thus, the patient will no present with typical symptoms |
| fever threshold in immunocompetent | 38.5 C |
| fever threshold in immunocompromised | 38.0 C |
| what are patients s/p lung transplant at greatest risk for | infection secondary to aspiration |
Created by:
Abarnard
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