9-Transplantation
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Questions and Answers

What are potential complications of diabetes mellitus type 1?

  • Hyperthyroidism, heart failure, osteoporosis
  • Asthma, allergies, eczema
  • Neuropathy, retinopathy, nephropathy (correct)
  • Obesity, hypertension, chronic fatigue syndrome

Which condition is characterized by frequent hypoglycemia and diabetic ketoacidosis (DKA)?

  • Gestational Diabetes
  • Type 2 Diabetes Mellitus
  • Brittle Diabetes Mellitus (correct)
  • Latent Autoimmune Diabetes in Adults (LADA)

In a liver transplant, where is the ideal surgical position located?

  • Left Thoracic Cavity
  • Right Iliac Fossa (correct)
  • Upper Abdomen
  • Lower Pelvic Area

Which of the following is a contraindication for pancreatic procedures?

<p>Chronic Pancreatitis (D)</p> Signup and view all the answers

What condition requires an intestine transplant in conjunction with total parenteral nutrition (TPN) failure?

<p>Irreversible Intestine Failure (B)</p> Signup and view all the answers

Which structures are divided during a hepatectomy?

<p>Ligamentous attachments, vascular structures, bile duct, portal structures, and vena cava (C)</p> Signup and view all the answers

Which of the following conditions could lead to pancreatic complications and warrant caution during procedures?

<p>Intraductal Papillary Mucinous Neoplasm (A)</p> Signup and view all the answers

What type of incision is commonly used for recipient operations in transplants?

<p>Bilateral subcostal incision with midline extension (C)</p> Signup and view all the answers

What is the primary mechanism leading to graft damage in humoral rejection?

<p>Antibody binding to donor’s HLA molecules (D)</p> Signup and view all the answers

What is the expected consequence of hyperacute rejection?

<p>Immediate and irreversible graft loss (B)</p> Signup and view all the answers

What major event is activated due to antibody binding in humoral rejection?

<p>Complement cascade activation (A)</p> Signup and view all the answers

Which type of host is involved in graft versus host disease?

<p>Immunocompromised host (D)</p> Signup and view all the answers

What is crucial in preventing hyperacute rejection?

<p>Pretransplant blood typing and crossmatching (B)</p> Signup and view all the answers

What characterizes the immune response in host versus graft rejection?

<p>Mounting an immune response to foreign antigens (B)</p> Signup and view all the answers

How does a graft versus host scenario arise?

<p>Donor's immune cells attack the recipient's tissues (B)</p> Signup and view all the answers

What is the end result of both types of rejection?

<p>Graft damage from inflammatory injury (B)</p> Signup and view all the answers

Which of the following is NOT true for Class III MHC?

<p>Example includes HLA-DR (D)</p> Signup and view all the answers

What defines xenotransplantation?

<p>Transplantation involving an organ from a different species (B)</p> Signup and view all the answers

Which statement correctly describes autotransplantation?

<p>Involves only organs from the same individual (D)</p> Signup and view all the answers

What is the primary mechanism of damage in humoral rejection?

<p>Circulating antibodies target and attack donor's HLA molecules (A)</p> Signup and view all the answers

Which of the following is a contraindication for kidney transplant?

<p>Active infection (A)</p> Signup and view all the answers

What type of transplant is an orthotopic procedure?

<p>Transplantation of organs in the recipient's original location (C)</p> Signup and view all the answers

Which procedure does NOT require immunosuppression?

<p>Autotransplantation (D)</p> Signup and view all the answers

What is the most significant factor in determining compatibility for organ transplantation?

<p>Matching of HLA antigens (B)</p> Signup and view all the answers

What is the ideal recipient position for kidney transplant HLA molecules?

<p>Iliac fossa (B)</p> Signup and view all the answers

Which of the following signs is NOT a warning sign of liver transplant rejection?

<p>Diarrhea (C)</p> Signup and view all the answers

Which irreversible liver disease is NOT an indication for liver transplant?

<p>Uncontrolled hepatic metastasis (B)</p> Signup and view all the answers

Which type of clinical rejection is caused by preformed antibodies against the donor's HLA?

<p>Hyperacute (D)</p> Signup and view all the answers

What is TRUE about chronic clinical rejection?

<p>The cause is not well understood (C)</p> Signup and view all the answers

Which of the following is a contraindication for pancreatic transplant?

<p>Intraductal Papillary Mucinous Neoplasm (D)</p> Signup and view all the answers

Which of the following options is associated with acute rejection?

<p>It occurs in the first days to weeks post-transplant (D)</p> Signup and view all the answers

Which condition is most directly related to hyperacute rejection?

<p>Presence of circulating antibodies (A)</p> Signup and view all the answers

What is the ideal relationship for an organ donor to maximally reduce the risk of rejection?

<p>An identical twin (B)</p> Signup and view all the answers

Which of the following is critical to ensure before organ transplantation?

<p>HLA-D region match (B)</p> Signup and view all the answers

When is antibacterial prophylaxis typically administered during an immunosuppression regimen?

<p>In the first 6 months (B)</p> Signup and view all the answers

What is the most common organ transplanted worldwide?

<p>Kidney (C)</p> Signup and view all the answers

Which condition is NOT typically an indication for small bowel transplantation?

<p>Ileus (B)</p> Signup and view all the answers

What percentage chance of success is indicated for a transplantation from a haplotype matched sibling?

<p>25% (A)</p> Signup and view all the answers

Which type of graft involves genetically identical members of the same species?

<p>Syngeneic graft (A)</p> Signup and view all the answers

Which of the following is NOT a common comorbidity affecting transplant success?

<p>Benign tumors (D)</p> Signup and view all the answers

What is the primary reason for the rejection of transplants in genetically nonidentical persons?

<p>Mismatched major histocompatibility complex (MHC) (A)</p> Signup and view all the answers

Which type of transplantation involves grafting an organ to a different anatomical location?

<p>Heterotopic transplantation (C)</p> Signup and view all the answers

What type of immune component is primarily responsible for cellular rejection of transplanted organs?

<p>Cytotoxic T lymphocytes (C)</p> Signup and view all the answers

Which transplantation type does NOT require immunosuppression due to immunological similarity between donor and recipient?

<p>Autotransplantation (A)</p> Signup and view all the answers

What is the function of HLA antigens in the immune response?

<p>To present protein fragments to T lymphocytes (D)</p> Signup and view all the answers

Which class of human leukocyte antigen is expressed by all nucleated cells?

<p>HLA-A (C)</p> Signup and view all the answers

What defines heterotopic transplantation?

<p>The graft is placed in a different anatomical position from its donor site. (A)</p> Signup and view all the answers

What is typically required when performing an allotransplantation?

<p>Immunosuppression (A)</p> Signup and view all the answers

Which organ system is primarily responsible for the biological recognition and immune response to transplanted tissues?

<p>Immune system (C)</p> Signup and view all the answers

What is the potential outcome when transplants are performed without understanding immunologic processes?

<p>Rejection of the transplanted tissue (B)</p> Signup and view all the answers

Which cellular defense is generally the first line of defense against pathogens during organ transplantation?

<p>Chemical and physical barriers (B)</p> Signup and view all the answers

In which organ transplantation type is the diseased organ maintained in place?

<p>Heterotopic transplantation (C)</p> Signup and view all the answers

What future experimental type of transplantation involves transferring tissue from animals to humans?

<p>Xenotransplantation (D)</p> Signup and view all the answers

Which cellular process predominantly triggers the rejection of transplanted organs?

<p>T lymphocyte activation (B)</p> Signup and view all the answers

Flashcards

Transplantation

The process of transferring an organ, tissue, or cell from one location to another.

Organ Transplantation

A surgical procedure where a failing organ is replaced with a functioning one.

Orthotopic Transplantation

The transplanted organ is placed in the SAME anatomical location in the recipient as it was in the donor.

Heterotopic Transplantation

The transplanted organ is placed in a DIFFERENT anatomical location.

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Heterotopic Transplantation

The diseased organ is KEPT IN PLACE.

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Autotransplant

Transfer of cells, tissues, or an organ from one part of the body to another part in the SAME person.

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Allograft

Transfer of cells, tissues, or an organ from one person to ANOTHER of the SAME species.

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Xenotransplant

Transfer of cells, tissues, or an organ from one organism to ANOTHER of a DIFFERENT species.

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Immune System

The body's defense system against foreign invaders, like bacteria and viruses.

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First Line of Defense

The first line of defense against foreign bodies.

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Second Line of Defense

The second line of defense against foreign bodies.

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Third Line of Defense

The third line of defense against foreign bodies.

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Major Histocompatibility Complex (MHC)

A group of genes that control the immune system's ability to recognize self from non-self.

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Human Leukocyte Antigen (HLA)

The MHC genes in humans, responsible for tissue and organ compatibility.

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Graft Rejection

The process by which the immune system rejects a transplanted organ.

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Hyperacute Rejection

This type of rejection is caused by pre-existing antibodies against the donor's HLA or ABO blood group antigens.

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Host vs. Graft Rejection

This rejection type is caused by the recipient's immune system recognizing and attacking foreign antigens on the donor's tissue.

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Graft vs. Host Rejection

This type of rejection involves the donor's immune cells attacking the recipient's tissues.

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HLA Molecules

The immune response to the donor's HLA (Human Leukocyte Antigens) molecules on the transplanted organ.

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HLA Typing

The process of identifying the compatibility between the donor's and recipient's HLA to prevent rejection.

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Cross-Matching

A test designed to detect the presence of pre-existing antibodies against the donor's cells to prevent hyperacute rejection.

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Pre-transplant Blood Typing

The process of mixing the donor's cells with the recipient's serum to determine if the recipient has pre-existing antibodies against the donor.

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Brittle Diabetes

A condition characterized by frequent hypoglycemia and diabetic ketoacidosis (DKA), often seen in type 1 diabetes.

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Hepatectomy

A type of liver transplant where the liver is removed and replaced with a new one.

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Orthotopic Transplant

A procedure where an organ, such as the liver, is placed in a different location from its original position.

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Vascular Anastomosis

A transplantation procedure involving the connection of blood vessels from the donor organ to the recipient's blood vessels.

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CHA Anastomosis

The connection of the common hepatic artery (CHA) to the new liver's blood supply, ensuring blood flow.

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Infrahepatic Vena Caval Anastomosis

The connection of the inferior vena cava (IVC) to the new liver's blood supply, allowing blood to flow from the liver back to the heart.

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Suprahepatic Vena Caval Anastomosis

A procedure involving connecting the superior vena cava (SVC) to the new liver's blood supply, ensuring proper blood flow.

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Autotransplantation

The transplantation of an organ from one part of the body to another part of the same body.

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Bilateral Subcostal Incision with Midline Extension

A surgical approach where incisions are made on both sides of the ribcage and extended along the midline.

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Allotransplantation

The transfer of an organ from one person to another of the same species.

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Humoral Rejection

The process of rejection occurs when the recipient's immune system recognizes the donor's tissue as foreign and attacks it. This is often mediated by antibodies.

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Contraindications for Kidney Transplant

This refers to a situation where a kidney transplant is not recommended due to the presence of other health conditions.

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MHC

A class of proteins found on the surface of cells that play a role in the immune system. They are involved in the recognition of foreign cells and antigens.

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Antigen Presenting Cells

A type of cell that presents antigens to T lymphocytes. These cells originate from nucleated cells and are crucial for immune responses.

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T-Lymphocytes

A type of white blood cell that plays a crucial role in the adaptive immune system. They recognize and attack specific antigens that are presented by antigen-presenting cells.

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Allograft Rejection

The rejection of a transplanted organ due to a difference in the MHC proteins between the donor and the recipient. The recipient's immune system sees the donor's organ as foreign and attacks it.

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Syngeneic transplantation

The transfer of an organ between genetically identical individuals, such as identical twins.

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Kidney Transplant

The most common type of organ transplant in the world.

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Where is a kidney transplant placed?

The ideal location for a kidney transplant in the recipient.

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What is hyperacute rejection?

The process of the immune system rejecting a transplanted organ due to the presence of pre-existing antibodies against the donor's HLA.

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What is hyperacute rejection caused by?

A type of clinical rejection that occurs when the immune system attacks the transplanted organ, triggered by antibodies that are already present in the recipient's blood.

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What is acute rejection?

A type of rejection that occurs within the first few months after transplantation when the immune system recognizes the transplanted organ as foreign.

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What is chronic rejection?

Rejection that develops gradually over time, often months or years after transplantation.

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Which irreversible liver disease isn't a reason for a liver transplant?

A serious liver condition that is NOT a suitable indication for a liver transplant.

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What is a contraindication for a pancreatic transplant?

This condition makes a patient unsuitable for pancreatic transplantation.

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Which of the following is NOT a warning sign of liver transplant rejection?

Jaundice is a symptom of liver transplant rejection, but diarrhea is not.

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Study Notes

Transplantations

  • Definition of Transplantation: The process of transferring an organ, tissue, or cell from one location to another.
  • Types of Transplantation:
    • Autotransplant: Transfer from one part of the body to another in the same person (e.g., skin grafts)
    • Allotransplant: Transfer between individuals of the same species (e.g., kidney transplant between humans)
    • Xenotransplant: Transfer between different species (e.g., animal to human transplants - usually experimental)
  • Host Defenses: First lines of defense are chemical and physical barriers (e.g., skin). Second line is the internal cellular defenses. Third line includes the immune response system that attacks and destroys foreign bodies.
  • Major Histocompatibility Complex (MHC): (Human Leukocyte Antigen [HLA] system in humans). These antigens are markers on cells that the recipient's immune system recognizes as foreign prompting rejection.
  • Graft Rejection: The body's immune system recognizing the transplanted organ as foreign and attacking it. This can happen in various ways (hyperacute, acute, and chronic).
  • Immunosuppression: Treatment to suppress the immune system, preventing rejection of a transplanted organ.
  • Kidney Transplant: A common transplant, often involving deceased donors.
  • Liver Transplant: Significant surgical procedure with significant risk and high potential for success.
  • Small Bowel Transplant: Used for patients with irreversible intestinal failure.

Clinical Rejection

  • Host vs Graft: Rejection caused by the immunocompetent host recognizing foreign antigens, triggering an immune response and organ rejection.
  • Graft vs Host: Caused by immunocompromised host, recipient receiving immunocompetent cells that recognize the host as foreign.
  • Hyperacute Rejection: Rapid, irreversible rejection of the transplanted tissue that occurs within minutes to hours. Often caused by preformed antibodies in the recipient.
  • Acute Rejection: Occurs within days to weeks post-transplant, triggered by immune response to graft antigens.
  • Chronic Rejection: Gradual and progressive rejection that occurs over months or years. It is often linked to irreversible tissue damage.

Other factors

  • Donor Selection: Critical for success, matching donor HLA type with patient.
  • Organ Procurement and preservation: Key for a successful transplant. Ensuring optimal organ function during the process, maintaining good conditions to the organ to ensure success.
  • Immunosuppression: Crucial to prevent rejection. Drugs, such as corticosteroids, calcineurin inhibitors, and others, are used.
  • Clinical Evaluation and Preparation: Pre and post-operative evaluation essential for assessing and minimizing organ risk prior and after transplant.
  • Kidney disease: A significant indication for kidney transplantation.
  • Liver Disease: A significant indication for liver transplantation.
  • Small Bowel Transplant: An option for individuals with severe small bowel disease. This results from irreversible intestinal failure in combination with TPN failure, where the intestine cannot function appropriately.
  • Pancreas Transplant: This is an option for individuals with insulin-dependent diabetes (IDDM) (Type 1 diabetes). This procedure results in normalization or improvement of glucose homeostasis, with a reduced risk of hypoglycemia and prevention or reversal of long term diabetes associated complications.

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Transplantation PDF

Description

Test your knowledge on diabetes mellitus type 1 complications and the intricacies of organ transplant procedures. This quiz covers essential aspects such as hypoglycemia, graft rejections, and surgical techniques relevant to managing these conditions. Perfect for healthcare students and professionals seeking to deepen their understanding.

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