病理学英文课件_7.4TransplantRejection_.pptVIP

Section 3 Transplant Rejection 1. Terms: Autograft: transplantation within the same individual Isograft or syngeneic graft: between identical twins or inbred animals Allograft: between individuals of the same species but of differing genetic make-up Xenograft: between different species. 2. Types of rejection (1) Superacute rejection: ①Time: within minutes or hours after transplantation. ②Causes: these are major incompatibility with high levels of humoral antibodies. ③Morphology: a. thrombotic occlusion of the capillaries b. Fibrinoid necrosis occurs in arterial walls. c. Infarction d. Neutrophils infiltrating (2) Acute rejection ① Time: Within days to weeks in the untreated recipient. Or may appear suddenly months or even years later, when immunosuppression has been employed. ② Types: a. Acute cellular rejection: diffuse mononuclear cell infiltrating that may invade the tubules, causing focal tubular necrosis, and edema as well as mild interstitial hemorrhage. b. Acute rejection vasculits (humoral rejection): necrotizing vasculitis with endothelial necrosis, neutrophils infiltration, deposition of immunoglobulins, complement, and fibrin, and thrombosis the vascular intima is markedly thickened and inflamed. (3) Chronic rejection ① Time: months——years ② Morphology: Vascular changes consist of dense intimal fibrosis; Interstitial fibrosis, tubular atrophy, shrinkage of the renal parenchyma; Mononuclear cell infiltrates containing large numbers of plasma cell and numerous eosinophils. It occurs in any situation in which immunologically component cells or their precursors are transplanted into immunologically crippled recipients. 3. Methods of increasing graft survival (1) Favourable sites for transplantation ① cornea and anterior chamber of the eye ② meninges ③ testis (2) Accurate tissue matching (3) Immune deficiency states, pregnancy, and uraemia (4) Immunosuppression ① Corticosteroids ② Azathioprine ③ Antilymphocyte serum