Surgery 2
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| a molecule that can interact with the immune system | antigen
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| peptides produced by B lymphocytes that attach to foreign material and aid in removing it from the body | antibody
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| cells that display foreign antigen complexed with MHC on its surface. | antigen presenting cell
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| 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
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| are encoded by the MHC genes | Human Leukocyte Antigens HLA
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| circulation peptides that influence behavior of the immune system (IL-2) | cytokines
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| a protein complex of T lymphocytes that can identify MHC molecules | T-Cell Receptor
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| interact with APC MHC II molecules via the TCR release cytokines (primarily IL-2) | CD4 lymphocyte
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| interact with MHC class I molcules (that contain foreign peptides) and can directly kill the foreign cell | CD8 T lymphocyte
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| of the same species | allogenic
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| 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
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| 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
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| a state of immune acceptance without immunosuppression | tolerance
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| MHC I goes with __ | CD8 T cells (8/1=8)
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| MHC II goes with __ | CD4 T cells (8/2=4)
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| what are the 2 allogenic recognition pathways | direct and indirect
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| 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
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| antilymphocyte antibodies used to prevent rejection until maintenance suppression is therapeutic | induction immunosuppression
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| the important cytokine to remember from the transplant lecture | IL-2
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| drugs that end in "-mab" are __ | monoclonal antibodies
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| when a transplanted organ is placed in its normal anatomic location in the recipient | orthograft
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| when a transplanted organ is placed in an area that is not its normal anatomic location in the recipient | heterograft
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| major cause of increased demand for organs | hepatitis C
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| 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
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| major histocompatibility complex MHC | genes expressed on the surface of cells in all jawed vertebrates and display fragments of foreign molecules to T cells
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| 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
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| which cytokine is responsible for the majority of immune cell activation | interleukin 2 IL-2
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| immediate killing of a transplanted organ occuring in patients with preformed antibodies to the donor in the bloodstream | hyperacute rejection
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| 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
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| chronic allograft vasculopathy due to development of atherosclerosis | chronic rejection
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| antilymphocyte antibodies used to prevent rejection during first few days after TP | induction immunosuppression
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| maintenance immunosuppression | long term therapy with two or three drugs
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| treatment of acute rejection | steroids and antilymphocyte preparations given over period of several days
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| most important side effect of cyclosporine | nephrotoxicity
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| most important complication of immunosuppression | opportunistic infection
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| how are donor organs transported | hypothermic storage with UW solution
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| why is the left kidney preferred in renal transplant | the renal vein is longer on the left side
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| what lab value is used to evaluate success of liver transplant | PT/INR
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| what lab value is used to evaluat the success of pancreatic transplant | glucose
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| 1-year survival rate following liver transplant | 85%
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| 1-year survival rate following heart transplant | 80%
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| 1-year survival rate following lung transplant | 70%
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| what imaging modality is used to evaluate liver and kidney anastomoses post-operatively | ultrasound
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| what consideration must be made regarding pancreas transplant | risk of diabetic complications vs complications of lifelong immunosuppression therapy
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| what clinical sign is associated with acute heart transplant rejection | tachycardia
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| 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
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| 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
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| fever threshold in immunocompetent | 38.5 C
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| fever threshold in immunocompromised | 38.0 C
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| what are patients s/p lung transplant at greatest risk for | infection secondary to aspiration
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Created by:
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