Transplant Rejection and Infections in immunodeficiency |Immunology | First Aid Lectures | Lec30
Channel: Dr. Jamil Lectures
Date: 20/04/2022

In this lecture we will discuss about transplant rejection types.Hyperacute rejection,Acute rejection,Chronic Rejection and Graft versus host disease.Also discussion about infections in different immune cells deficiencies.


https://youtu.be/ft9HRw8NNWY
https://youtu.be/1R2r_eMHAqA
https://youtu.be/aP06bUvyqCA

Instagram account    dr_jamil56
Hyperacute Rejection
Within minutes
 Pre-existing recipient antibodies 
react to donor antigen (type II 
hypersensitivity reaction), activate
complement
Widespread thrombosis of graft 
vessels (arrows within glomerulus A) 
 ischemia/necrosis
Graft must be removed

Acute Rejection
Weeks to months 
Cellular: CD8+ T cells and/
or CD4+ T cells activated 
against donor MHCs (type IV 
hypersensitivity reaction)
Humoral: similar to hyperacute, 
except antibodies develop after 
transplant
Vasculitis of graft vessels with dense 
interstitial lymphocytic infiltrate  B
Prevent/reverse with 
immunosuppressants
Chronic Rejection
Months to years 
CD4+ T cells respond to recipient 
APCs presenting donor peptides, 
including allogeneic MHC
Both cellular and humoral 
components (type II and IV 
hypersensitivity reactions)
Recipient T cells react and 
secrete cytokines  proliferation 
of vascular smooth muscle, 
parenchymal atrophy, interstitial 
fibrosis
Dominated by arteriosclerosis C
Organ-specific examples:
 Chronic allograft nephropathy
 Bronchiolitis obliterans
 Accelerated atherosclerosis 
(heart)
 Vanishing bile duct syndrome
Graft-versus-host disease
Varies Grafted immunocompetent 
T cells proliferate in the 
immunocompromised host and 
reject host cells with “foreign” 
proteins  severe organ 
dysfunction
Type IV hypersensitivity reaction
Maculopapular rash, jaundice, 
diarrhea, hepatosplenomegaly
Usually in bone marrow and liver 
transplants (rich in lymphocytes)
Potentially beneficial in bone 
marrow transplant for leukemia 
(graft-versus-tumor effect)
For immunocompromised patients, 
irradiate blood products prior to 
transfusion to prevent GVHD





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