Chapter 17 Study Guide Define the following terms:Graft Donor Recipient Host Graft Graft rejection Allogeneic Autologous graft Allogeneic graft Xenogeneic graft Syngeneic graft Polymorphism Codominance Allograft Alloantigen Alloantibody Xenoantigen Transplant Transfusion HLA MHC allele MHC restriction Alloreactive Alloreactive cells Alloreactive antibodies Alloreactive MHC Direct allorecognition Sensitization Hyperacute rejection Acute rejection Chronic rejection Pathology Necrosis Ischemia Thrombosis Parenchyma Vascular occlusion Immunosuppression ABO blood typing Cross-matching HLA Tissue typing Flow cytometry Panel reactive test Cyclosporine Corticosteroid Blood transfusion A antigen B antigen H antigen Universal donor Universal recipient Rh antigen Bombay blood group Hemolysis Stem cell transplant GVHD Immunodeficiency Leukemia RhoGAM Erythroblastosis fetalis Agglutination (aggregation of RBCs) Percent reactive antibody Mixed lymphocyte reaction Indirect allorecognition Human leukocyte antigen Major histocompatibility antigens Minor histocompatibility antigens Learning Objectives - Important concepts to know At the end of this chapter, you should be able to: 1. Identify the most common type of tissue transplant. 2. Explain the relationship between donor, recipient, and graft. 3. Describe the purpose and procedure (the steps) of the experiment in Figure 17-2 in your text. In addition, what did the researchers learn from this (what did this experiment demonstrate)? 4. Compare the genetics from the various types of grafts discussed: allogeneic, autologous, syngeneic, and xenogeneic. Discuss the experiment that determined these different types of grafts (Figure 17-3 in your text).5. Identify the primary concern when performing a tissue transplant (from an immunology perspective). 6. Compare direct and indirect allorecognition, including: a. the mechanism of each type of allorecognition b. the specific donor and/or recipient cells involved in each allorecognition c. the composition of peptides presented to immune cells in each type of allorecognition d. the location in which the recognition is occurring 7. Discuss the process of sensitization in respect to tissue transplants and how it contributes to graft rejection. A good exercise is being able to describe the entire process from sensitization to graft rejection, how is graft rejection mediated, how the cells are activated and mature into effector cells (including their function), and how the cells circulate through the body using chemokines and chemokine receptors. 8. Discuss the purpose and procedure (the steps) of the mixed lymphocyte reaction (although there are one-way and two-way MLRs, please focus on the one-way MLR). What is the interpretation of a positive MLR? A negative MLR? 9. Compare the types of transplant rejection, including: a. how each type of transplant rejection is initiated/mediated b. the timeline of the tissue rejection post-transplantation c. the mechanism of transplant rejection (including the tissues/locations, cells, cytokines, or antibodies and their isotypes involved) d. the pathologic findings associated with the tissue rejection 10. Discuss the various ways we can try to prevent transplant rejection (either prior to the transplant or after the transplant). 11. Discuss the correlation between HLA alleles, transplant rejection, and 5-year survival post transplantation. 12. What are alloreactive antibodies and how can they be produced? How are they tested for? 13. Discuss the various immunotherapies used to prevent transplant rejection. What specific role do each of these immunotherapies play in immunosuppression? 14. List the blood group antigens that determine an individual’s blood type. How are these blood group antigens made? What are the 4 major blood types? How are these different from the Bombay blood group?15. Given the blood type of an individual, identify the blood group antigens that would be found on their red blood cells, as well as the antibodies they would be expected to have in their serum. 16. Identify the blood type which is the universal donor and which is the universal recipient. In addition, you should be comfortable in identifying what blood type individuals of differing blood types could receive if a blood transfusion is needed. 17. Explain the Rh antigen and its role in immunology, blood typing, and in pregnancy. 18. Describe the purpose of a stem cell transplant. What are the possible complications of stem cell