Graft Vs Host Disease Essay

In order for transplants to be successful, there are steps that should be followed. From the beginning, the correct information should be given prior to

What causes this disease is, after the transplant is complete the cells, of the transplanted bone marrow or stem cell, start attacking the recipient’s body. GVHD has a wide range of how dangerous it can be to the patient’s life, it can range from mild, where it is easily treatable, to life threatening, where there is no stopping the donor cells from attacking the recipient’s body. A biopsy on an affected organ can determine diagnoses of GVHD grade from I (mildest) to IV (most severe). To prevent GVHD, a couple of days before the transplant multiple drugs are prescribed to the patient: cyclosporine and methotrexate, tacrolimus and methotrexate, tacrolimus and mycophenolate mofetil, or prograf and sirolimus. These drugs are to lower the immune system from attacking the donor’s cells. The outlooks of a patient after the transplant is determined on how severe GVHD is and how closely match the bone marrow tissue or cell was. There have been some cases where GVHD caused damage to the liver, lungs, digestive tract and other organs. However, if this does happen or the patient start developing symptoms of GVHD, there are treatments. But the treatments does not always guarantee that the transplant will treat the original disease that was meant for the bone marrow tissue or cell transplant.

Autologous transplant is when your own hematopoietic stem cells are removed before a high dose of

Despite continuous opposition towards the advancements, irrefutable evidence suggests that transplants can provide life-changing results and vast improvements in life quality for the people who receive these operations. While undergoing a transplant-based procedure, one does not risk the unsuccess or adverse effects that

Describe how and why both types of adaptive immunity can cause problems with organ transplantation.

Another health problem that treatment with embryonic stem cells can cause is tissue rejection. As is the case with current organ transplantation procedures, embryonic stem cells are harvested from many people all who possess a unique set of genes; therefore, the stem cells are not genetically matched for each patient (Herold 48-49). The difference in genetics causes the body to reject the tissue and the immune system begins to attack the transplanted tissue like it would a virus or bacteria in an attempt to remove the perceived threat. To avoid the implanted tissues being rejected by the body, doctors must prescribe immune suppression drugs that must be taken for the remainder of the patient’s life, even with these drugs the tissue may still be rejected and

The Stanford group has performed a series of clinical trials using CD34+ purified cell transplants to induce tolerance to an HLA matched and mismatched living kidney donation. The first six patients were transplanted between 2000 and 2003 and had HLA-disparate donors104. Both related and unrelated patient/donor pairs ranged from a 3/6 to 0/6 HLA match. Six weeks before transplantation, the donors were treated with five doses of G-CSF for bone marrow mobilization. They then completed leukapheresis to harvest the peripheral blood mononuclear cells. The researchers selected the CD34+ mononuclear cells using a magnetic bead column resulting in >75% purity. Recipient conditioning included IV infusion of 1.5mg/kg rabbit ATG on days 1, 3, 5, 9, and 14 post-transplant and daily TLI (80cGy/dose for four

This article discusses the specific details of cardiac allograft vasculopathy (CAV) in transplant patient recipients. The article is a review that includes an extensive explanation of the pathogenesis, and thus the characteristics, of CAV along with the immunosuppressive therapy necessary for allograft survival. Specifically, the article will be most beneficial in elaborating on the indirect allorecognition pathway that induces the cellular alloimmune response. This response is believed to be the primary cause of cardiac allograft vasculopathy and allograft vasculopathy in the remaining organs as well, which leads to the chronic rejection of a transplanted organ. Although secondary to the cellular alloummune response, nonimmunological factors

A procedure known as transplantation consists of the transfer of cells, tissue or organ from one part of the body to another or from one person to another (National Cancer Institute, no date). Haemopoietic stem cells (HSCs) are unspecialized cells that have the ability to self-renew and the ability to differentiate into the HSCs lineage (Figure 1) for instance as white blood cells (WBCs), red blood cells (RBCs) and platelets. Treatment for a range of haematological disorders usually requires transfusion and transplantation (Knight, 2013). To obtain HSCs for transplantation there are three main sources. They are the bone marrow (BM), peripheral blood stem cells (PBSCs) and umbilical cord blood (UCB) (Smith and Wagner, 2010). A haploidentical donor is another source where the HLA match is not complete and there is a match of one haplotype. HSCs can be transplanted by an autologous, allogeneic and syngeneic donor (Hatzimichael and Tuthill, 2010). HSCs transplantation is carried out to eliminate the condition by myeloablation (prevent immune system attacking/rejecting new graft), to prevent the body being attacked by the new immune system derived from the new HSCs by graft versus host disease (GvHD) and to avoid rejection of the graft by immunosuppression (Buckland, 2017).

Patients who underwent this procedure had to remain on immunosuppressive drugs for about 6 months to prevent the recipient’s immune system from destroying the donor cell. One out of seven patients that had this procedure done had a relapse because they stopped taking their immunosuppressant drug during the critical stage of treatment. This treatment has proven successful, but there still remains the concern of tissue rejection and other complication. Nevertheless, this approach still provides encouragement for people suffering with the disease.

A collaboration between NU and ICT utilized FC and HSC combined therapy with living related and unrelated donor renal transplantation. As previously described FC are bone marrow derived cell population that enables engraftment of HSC in HLA-matched and HLA-mismatched donors without causing GVHD 84. The NU/ICT group has developed a nonmyeloablative reduced-intensity conditioning approach to establish high levels of donor chimerism with minimal GVHD and no engraftment syndrome in mismatched related and unrelated allogeneic recipients of combined kidney/HSC/FC transplants 107-110. A tolerance-promoting FC-based HSC graft, named FCRx product consists of a G-CSF mobilized PBMC apheresed from the donor, processed to remove GVHD-producing

Histocompatibility and Immunogenetics (H&I) is the branch of Clinical Science (Blood sciences) involved in HLA typing and screening for solid organ and haematopoietic stem cell transplants (Histocompatibility) and the genetics of major histocompatibility complex associated disease (immunogenetics). Clinical scientists within this field have limited patient interactions yet must still embody professional practice. Each of the following statements will examine aspects of professional practice and how they impact on clinical scientists within H&I.

The role of NK cells in haploidentical transplants was pioneered by the Perugia group as discussed earlier in this chapter 31-33. A follow up study published in 2007 included the 57 patients with AML whose outcomes were reported in the seminal 2002 study, in addition to 52 patients who received a transplant after the original publication. 33 All patients evaluated received a myeloablative T cell depleted haploidentical transplant 33. Alloreactions in the graft versus host direction were identified in 51 patients 33. In contrast to the initial study, transplantation from alloreactive NK cells did not significantly reduce graft rejection or incidence of GVHD. Despite no increased protection from GVHD, there was a marked improvement in

Organ transplantation is a medical act which involves the surgical operating by transferring or removing of an organ from one person to the other, or placing the organ of a donor into the body of a recipient for the replacement of the recipients damaged or failed organ which resulted from impairment of normal physiological function affecting part or all of an organism or an act that causes someone to receive physical damage.

HLA cross matching is when a recipients’ blood is tested for HLA typing and listed in UNOS registry. This allow for better matching between donors and recipients. Sometimes HLA matching is not always used in heart, lung, and liver transplants and this is due to the critical state these patients are in. HLA matching is used in kidney and stem cell transplants when more accurate HLA matching is needed for long term survival. There was systematic review and meta-analysis done by Ansarai, Bucin, and Nilsson (2014) that looked at studies on HLA matching in heart transplants. What they found is there was an increased graft survival and decreased rate of rejection. However, there was not a lot of RCTs. This was a major limitation. They did recommend using class two alleles. They appear to have a better benefit rather than