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</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</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</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</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</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</p> Signup and view all the answers

    What is the expected consequence of hyperacute rejection?

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

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

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

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

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

    What is crucial in preventing hyperacute rejection?

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

    What is the end result of both types of rejection?

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

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

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

    What defines xenotransplantation?

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

    Which statement correctly describes autotransplantation?

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

    Which of the following is a contraindication for kidney transplant?

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

    Which procedure does NOT require immunosuppression?

    <p>Autotransplantation</p> Signup and view all the answers

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

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

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

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

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

    <p>Diarrhea</p> Signup and view all the answers

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

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

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

    <p>Hyperacute</p> Signup and view all the answers

    What is TRUE about chronic clinical rejection?

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

    Which of the following is a contraindication for pancreatic transplant?

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

    Which condition is most directly related to hyperacute rejection?

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

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

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

    When is antibacterial prophylaxis typically administered during an immunosuppression regimen?

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

    What is the most common organ transplanted worldwide?

    <p>Kidney</p> Signup and view all the answers

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

    <p>Ileus</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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

    <p>Autotransplantation</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</p> Signup and view all the answers

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

    <p>HLA-A</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.</p> Signup and view all the answers

    What is typically required when performing an allotransplantation?

    <p>Immunosuppression</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</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</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</p> Signup and view all the answers

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

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

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

    <p>Xenotransplantation</p> Signup and view all the answers

    Which cellular process predominantly triggers the rejection of transplanted organs?

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

    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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    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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