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Transplant Rejection Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
The following is an excerpt....
BASICS
Description
  • A transplant recipient’s immune response to a graft’s genetically dissimilar antigens resulting in rejection of the transplanted organ
  • HLA incompatibility:
    • Most common cause of rejection
    • Rejection of solid organ transplants
  • Antibodies blood group incompatibility:
    • Much less of a risk to graft survival than HLA incompatibility
    • May result in hyperacute rejection of primarily vascularized grafts, such as kidney and heart
  • 3 phases of rejection:
    • Hyperacute:
      • Occurs in the immediate postoperative period
      • Antibody reaction to red cells or HLA antigens
      • Endothelial damage
      • Platelets accumulate, thrombi develop, and tissue necrosis occurs.
      • Rare with careful donor–recipient matching
    • Acute:
      • Usually occurs within the 1st months after transplantation but may happen at any time if immunosuppressant medication is stopped
      • T cell ...

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