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Q.Explain the prevention of graft rejection in the clinical field.

Tamil Nadu DgeTamil Nadu HSC (DGE) Board 2018Subjective· 5mImportance★★★★★
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Graft rejection is prevented by matching donor and recipient tissue (HLA) and blood group closely and by giving immunosuppressive drugs (e.g. cyclosporin-A, steroids) that hold back the recipient's immune attack.

When tissues or an organ (a graft) are transplanted from a donor to a genetically different recipient, the recipient's immune system recognises the graft's surface antigens (major histocompatibility complex / HLA antigens) as foreign. T-lymphocytes then attack and destroy the transplanted tissue — this is graft rejection. In clinical transplantation (kidney, heart, liver, skin, etc.), rejection must be prevented for the graft to survive.

Measures to prevent graft rejection:

  1. Tissue (histocompatibility) matching: before transplant, the HLA antigens of donor and recipient are typed and matched as closely as possible. The more similar the HLA types, the weaker the immune reaction. Grafts between identical twins (isografts) are not rejected; grafts from close blood relatives are matched best. This is why donor selection and tissue typing are essential.
  2. Blood group matching: the ABO blood groups of donor and recipient are matched to avoid reaction.
  3. Immunosuppression: the recipient is given immunosuppressive drugs that dampen the immune response so it does not reject the graft. These include:
  • Cyclosporin-A (suppresses T-lymphocyte activity — a very effective drug),
  • Corticosteroids (e.g. prednisolone), and
  • Antimetabolites/cytotoxic drugs (e.g. azathioprine). …

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