Immunology of Renal Transplant

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IMMUNOLOGY OF TRANSPLANTATION

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Presentation transcript:

Immunology of Renal Transplant Ahmad Jaber ALMUJALHEM-K.U.B. R III-Academic Day 30th Jan 2014

Outline Immunology in Urology Selection & Preparation of kidney transplant: Recipient Donor RENAL ALLOGRAFT REJECTION Classification of Rejection

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

Facts!

Facts!

SELECTION AND PREPARATION OF KIDNEY TRANSPLANT RECIPIENTS Preliminary Screening Next…

Recipient Next…

Donor Next…

RENAL ALLOGRAFT REJECTION Next…

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

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

http://www. intechopen http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/current-and-future-directions-in-antibody-mediated-rejection-post-kidney-transplantation

Nature Reviews Nephrology 8, 670-678 (November 2012) | doi:10 Nature Reviews Nephrology 8, 670-678 (November 2012) | doi:10.1038/nrneph.2012.212

http://www. intechopen http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/tolerance-in-renal-transplantation

symptoms of acute kidney transplant rejection “the flu” accompanied by pain Enlarged kidney graft Hypertension Decreased urinary output Fluid retention Increased serum creatinine levels

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

Immunosuppression

http://ukhealthcare.uky.edu/trans/cardiovascular-disease/

http://www.sgh.com.sg/about-us/newsroom/News-Articles-Reports/Pages/Betterdrugsprolongkidneytransplantpatients'lives(SingaporeHealthIssue,May-June2013,Pg5).aspx

Thanks Question Discussion