immunology of renal transplant ahmad jaber almujalhem-k.u.b. r iii-academic day 30 th jan 2014
TRANSCRIPT
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Immunology
of Renal Transplant
Ahmad Jaber ALMUJALHEM-K.U.B. R III-Academic Day 30th Jan 2014
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Outline
Immunology in Urology
Selection & Preparation of kidney transplant:
Recipient
Donor
RENAL ALLOGRAFT REJECTION
Classification of Rejection
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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
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Facts!
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Facts!
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SELECTION AND PREPARATION OFKIDNEY TRANSPLANT RECIPIENTS Preliminary Screening Next…
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Recipient
Next…
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Donor
Next…
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RENAL ALLOGRAFT REJECTION
Next…
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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
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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
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http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/current-and-future-directions-in-antibody-mediated-rejection-post-kidney-transplantation
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Nature Reviews Nephrology 8, 670-678 (November 2012) | doi:10.1038/nrneph.2012.212
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http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/tolerance-in-renal-transplantation
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symptoms of acute kidney transplant rejection “the flu” accompanied by pain Enlarged kidney graft Hypertension Decreased urinary output Fluid retention Increased serum creatinine levels
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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
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Immunosuppression
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http://ukhealthcare.uky.edu/trans/cardiovascular-disease/
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http://www.sgh.com.sg/about-us/newsroom/News-Articles-Reports/Pages/Betterdrugsprolongkidneytransplantpatients'lives(SingaporeHealthIssue,May-June2013,Pg5).aspx
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