Transplantation Immunology

When different talents and ideas rub up against each other, there is friction, yes.
But also sparks, fire, light and - eventually- brilliance.
Nancie O’Neill

Who am I? I was born in Brazil in 1915. I shared the 1960 Nobel Prize with Macfarlene Burnet for my experiments that showed that mouse embryos inoculated with foreign tissues became tolereant to them.

RESOURCES

Bone Marrow Transplant procedure information

This site hosted by SUNY, Plattsburgh provides information about bone marrow transplantation. The site contains some general information about the human immune system, bone marrow transplantation, and the BMT procedures. There are also additional Internet links, references, and FAQs.

URL --> http://137.142.42.95/BMTCancer/BMT.html

Bone Marrow Transplant information (Oncolink)

This is a meta site full of links for resources on bone marrow transplantation. There is also a very comprehensive online book about bone marrow transplantation geared toward the patient.

URL --> http://oncolink.upenn.edu/specialty/chemo/bmt/

Bone Marrow Transplant News

This is the home page for the Blood and Bone Marrow Transplant Newsletter. Issues from Januray, 1994 through August, 1997 can be accessed online.

URL --> http://nysernet.org/bcic/bmt/bmt.news.html

Brigham and Women's Hospital's Lung Transplant Program

This is the home page for a clinical organ transplant center at Brigham and Women's Hospital, Boston.

URL --> http://bustoff.bwh.harvard.edu/thoracic/ThoracicLungTX.html

Dartmouth-Hitchcock Medical Center's Renal Transplant Program

This is the home page for a clinical organ transplant center at Dartmouth-Hitchcock Medical Center.

URL --> http://www.hitchcock.org/pages/renaltrans/RenTransp.html

Rush Heart Transplant Program

This is the home page for a clinical organ transplant center at Rush Medical Center.

URL --> http://www.rpslmc.edu/Med/Heart/hf.html

Stanford University Medical Center Transplant Program

This is the home page for a clinical organ transplant center at Stanford University Medical Center.

URL --> http://www-med.stanford.edu/shs/txp/

University of Arizona Medical Center Transplant Program

This is the home page for a clinical organ transplant center at the University of Arizona Medical Center.

URL --> http://www.ahsc.arizona.edu/~umc/advanced.htm

University of California, Los Angeles' Transplant Program

This is the home page for a clinical organ transplant center at the University of California, Los Angeles.

URL --> http://www.medctr.ucla.edu/dept/xplant/default.htm

University of California, San Diego's Heart Transplant Program

This is the home page for a clinical organ transplant center at the University of California, San Diego.

URL --> http://medicine.ucsd.edu/chfpro/

University of Nebraska Medical Center's Pediatric Bone Marrow Transplant Program

This is the gopher site for a clinical bone marrow transplant center at the University of Nebraska Medical Center.

URL --> gopher://gopher.unmc.edu/11/Pediatrics

University of Texas Immunology & Organ Transplantation

This is the home page of the University of Texas Immunology & Organ Transplantation Center. There is a link to a section on immunosuppresants and on current clinical trials.

URL --> http://surgery.uth.tmc.edu/organ_transplant/

Transplantation (Journal)

This is the home page for Transplantation, the official journal of the Transplantation Society.

URL --> http://www.wwilkins.com/TP/

TransWeb

This web site is dedicated to providing information about transplantation and organ donation. Information is available for both patients and physicians. Additional Internet links relating to these topics are also available.

URL --> http://www.transweb.org/

ASSIGNED READING

CHAPTER 23: pp 555-572

OUTLINE/SUMMARY

1. Immunological Basis of Graft Rejection
   • Specificity & memory
   • Cell mediated responses
   • Transplantation antigens
   • Mechanisms of graft rejection
   • Sensitization stage
   • Effector stage
2. Clinical Manifestions of Graft Rejection
   • Hyperacute rejection
   • Acute Rejection
   • Chronic rejection
3. Tissue Typing
4. General Immunosupressive Therapy
   • Mitotic inhibitors
   • Corticosteroids
   • Cyclosporin A
   • Total irradiation
5. Specific Immunosupressive Therapy
   • MABs to T cells
   • Block co-stimulatory signal
   • Microchimeras
6. Clinical Transplantation
   • Bone marrow transplants
   • Organ transplants
   • Xenotranplants
   • Immunologically priveleged sites

PERFORMANCE OBJECTIVES

DEFINE THE FOLLOWING KEY TERMS:

ON COMPLETION OF THIS SECTION THE STUDENT SHOULD BE ABLE TO:

1. Show that the cell mediated response to transplants in the same as the immune response to any other foreign antigen
2. Describe four types of grafts
3. Describe the five transplantation laws
4. Distinguish among first set rejection, second set rejection and chronic rejection;
5. Differentiate between host versus graft reaction and graft versus host reaction.
6. Compare the contribution of Class I and Class II MHC to graft rejection.
7. Comment on which T cells are responsible for graft rejection
8. Describe serologic tissue typing.
9. Describe the mixed lymphocyte reactions and why you would want to use the MLR in tissue typing
10. Rank the success rate for transplants of different tissues and organs

SHORT ANSWER QUESTIONS

1. What do we mean when we say that the immune system is the greatest obstacle to most transplants?
2. What is the difference between autograft and syngraft? Give examples of both.
3. How do we know that the immune system is involved in allograft rejection?
4. Are antibodies or T cells the main mediators of rejection?
5. ompare and contrast first set rejection and second set rejection.
6. What does second set rejection suggest about the similiarity of transplantation antigens?
7. What conditions could lead to a graft vs host response (GvHR)?
8. Even though class II antigens are found mainly on immune cells, they can still contribute to graft rejection. How?
9. What may be the biologic significance of alloreactivity?
10. Describe serologic tissue typeing.
11. Describe the MLR. Why is this test done in addition to serologic tissue typing?
12. Differentiate between privileged sites and privileged tissues.