Immunology of Renal Transplant Ahmad Jaber ALMUJALHEM-K.U.B. R III-Academic Day 30 th Jan 2014.
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Transcript of Immunology of Renal Transplant Ahmad Jaber ALMUJALHEM-K.U.B. R III-Academic Day 30 th Jan 2014.
Immunology
of Renal Transplant
Ahmad Jaber ALMUJALHEM-K.U.B. R III-Academic Day 30th Jan 2014
Outline
Immunology in Urology
Selection & Preparation of kidney transplant:
Recipient
Donor
RENAL ALLOGRAFT REJECTION
Classification of Rejection
Immunology in Urology
Immunocompromised patient
Auto Immune diseases
Wound healing and Immune system
Neoplasm and Immune system
Infection and Immune system
Infertility and Immune system
Vaccine
Immunotherapy
Immunosuppressant
Facts!
Facts!
SELECTION AND PREPARATION OFKIDNEY TRANSPLANT RECIPIENTS Preliminary Screening Next…
Recipient
Next…
Donor
Next…
RENAL ALLOGRAFT REJECTION
Next…
Histocompatibility ABO blood group Major histocompatibility complex (MHC): Class I antigens:
HLA-A, HLA-B & HLA-C T lymphocytes
Class II antigens: HLA-DR,HLA-DQ, HLA-DP
B lymphocytes, activated T lymphocytes, monocytes, macrophages,dendritic cells &some endothelial cells
Classification of Rejection Hyperacute rejection:
Immediately after renal revascularization Irreversible process Mediated by preformed circulating cytotoxic antibodies
Accelerated rejection: Mediated by humoral and cellular components Within days to weeks Does not respond to antirejection therapy.
Acute rejection (any time after transplantation) Chronic rejection:
Gradual decline in renal function Interstitial fibrosis Vascular changes Minimal mononuclear cell infiltration
http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/current-and-future-directions-in-antibody-mediated-rejection-post-kidney-transplantation
Nature Reviews Nephrology 8, 670-678 (November 2012) | doi:10.1038/nrneph.2012.212
http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/tolerance-in-renal-transplantation
symptoms of acute kidney transplant rejection “the flu” accompanied by pain Enlarged kidney graft Hypertension Decreased urinary output Fluid retention Increased serum creatinine levels
Dx Needle biopsy of the kidney graft is the
standard to confirm the diagnosis of acute rejection.
Typical histologic findings of acute renal allograft rejection: Mononuclear cellular infiltration Tubulitis Vasculitis
Immunosuppression
http://ukhealthcare.uky.edu/trans/cardiovascular-disease/
http://www.sgh.com.sg/about-us/newsroom/News-Articles-Reports/Pages/Betterdrugsprolongkidneytransplantpatients'lives(SingaporeHealthIssue,May-June2013,Pg5).aspx
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