Case 4 - Transplant Rejection

• What is the immunopathological mechanism of acute transplant rejection?

  Driven by T cells (not autoimmune, as it is agiainst harmless alloantigens)

  Direct recogntion of alloantigens (due to it being acute)

  Donor APC present MHC directly to recipient T cells -> recipient T cell activation -> damages graft & secrete inflammatory cytokines
• What type of hypersensitivity is transplant rejection?

  Type IV
• How can we reduced the risk of transplant rejection?

  MHC matching

  Immunosuppressant regime (tacrolimus, mycophenolayte mofetil, prednisolone)
• What is tacrolimus?

  Calcineurin inhibition

  Inhibits activation of T cells
• What is mycophenolate mofetil?

  Immunosuppressant

  Inhibits synthesis of GMP -> inhibits cell proliferation
• What are the signs & symptoms of transplant rejection?

  Reduced organ function

  Pain the the site

  Systemic symptoms of inflammation (fever etc.)