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Question 41 of 70

Q.Write the various symptoms of graft rejection and its clinical prevention.

Tamil Nadu DgeTamil Nadu HSC (DGE) Board 2017Subjective· 5mImportance★★★★★
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Graft rejection is the recipient's immune attack on transplanted tissue perceived as non-self, recognisable by characteristic local and systemic symptoms, and is minimised clinically through pre-transplant matching and post-transplant immunosuppression.

Why rejection occurs

  • Transplanted tissue carries donor MHC/HLA (human leukocyte antigen) molecules that differ from the recipient's own, so the recipient's T-cells and antibodies recognise the graft as foreign and mount an immune response against it.

Types and symptoms

  1. Hyperacute rejection (minutes to hours) -- caused by pre-existing antibodies in the recipient (e.g., from ABO mismatch); the graft rapidly turns dusky/mottled, clots form in its blood vessels, and it fails almost immediately.
  2. Acute rejection (days to a few weeks) -- the most common type, mediated mainly by T-cells; symptoms include fever, pain and tenderness/swelling at the graft site, malaise, and organ-specific signs such as reduced urine output and raised creatinine (kidney graft), jaundice (liver graft), or redness, blistering and sloughing (skin graft).
  3. Chronic rejection (months to years) -- a slow, progressive process involving both immune and non-immune injury, leading to gradual fibrosis/scarring and irreversible decline in graft function over time.

Clinical prevention

  • Pre-transplant matching: ABO blood-group compatibility and HLA (tissue) typing between donor and recipient, followed by a cross-match test to confirm the recipient has no pre-formed antibodies against donor cells. …

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