Incidence is high (30%) for the first 90 days
T-cell, macrophage and Ab mediated,
myocyte and endothelial damage,
Occurs in most solid organ transplants
Characterized by fibrosis and vascular abnormalities with loss of graft function over a prolonged period.
Macrophage – T cell mediated
Concentric medial hyperplasia
Chronic DTH reaction
Today it is possible to transplant many different organs and tissues including.
Most common transplantation is blood transfusion.
Bone Marrow transplantation
Organs : Heart, kidneys, pancrease, lungs, liver and intestines.
Tissues : include bones, corneas, skin, heart values, veins, cartilage and other connective tissues.
Most Common Transplantation -Blood Transfusion-
Used for Leukemia, Anemia and immunodeficiency, especially severe combined immunodeficiency (SCID).
About 109 cells per kilogram of host body weight, is injected intravenously into the recipients.
Recipient of a bone marrow transplant is immunologically suppressed before grafting.
Eg. Leukemia patients are often treated with cyclo-phosphamide and total body irradiation to kill all cancerous cells.
Because the donor bone marrow contains immunocompetent cells, the graft may reject the host, causing graft versus host disease (GVHD).
Caused by the reaction of grafted mature T-cells in the marrow inoculum with alloantigens of the host
Characterized by epithelial cell death in the skin, GI tract, and liver
Characterized by atrophy and fibrosis of one or more of these same target organs as well as the lungs
Heart Transplantation :
First heart transplant in South Africa by Dr. Christian Barnard in 1964.
One year survival rate is >80%.
HLA matching is desirable but not often possible, because of the limited supply of heart and the urgency of the procedure.