Priniciples of transplantation. February 19 2008. Goals and objectives. Principal components Role of HLA in immunogenic response Understand the 3 signal pathway of T cell activation and its clinical significance. Classification of grafts. Autologous grafts
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February 19 2008
Grafts transplanted from one part of the body to another in the same individual
Grafts transplanted between two genetically identical individuals of the same species
Allogeneic grafts (Allografts)
Grafts transplanted between two genetically different individuals of
the same species
Xenogeneic grafts (Xenografts)
Grafts transplanted between individuals of different species
CD 4 T cells – Antigen specific immune response
CD8 T cells - Precursors of CTL – Class I MHC
Klein J and Sato A. N Engl J Med 2000;343:702-709
Class I MHC
Class II MHC
Class II system is designated to sample extracellular proteins by extracellular proteins by specialized APC’s
HLA genes are co dominant: A protein from each parental gene is expresed on cell-surfaces
Variability map of Class 1 MHC α Chain
Variability map of Class2 MHC β Chain
3 year graft surivival 93 and 85% for HLA matched and mismatched live donors
In cadaveric grafts 82 and 76%
Most benefit with zero mismatches
CD 154 and CD 25.
The activated T cells rapidly accumulate in the interstitium of the allograft as the response mounts in the first few days.