Rheumatology and Immunology Therapy

2004 Edition

Graft rejection

Reference work entry
DOI: https://doi.org/10.1007/3-540-29662-X_1144
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Synonyms

Allograft rejection.

Definition

Graft rejection is the result of the recipient's immunologic response to an implanted organ resulting in loss of function and death of that organ. There are four types of graft rejection that are defined by timing after organ transplantation and immunologic mechanisms:

  1. 1.

    Hyperacute rejection

    1. a.

      Due to preformed antibodies (ABO blood groups, transfusion, pregnancy)

       
    2. b.

      Transplanted organ rejected within minutes or hours

       
    3. c.

      Kidneys turn blue and urine output ceases

       
    4. d.

      Activation of complement (membrane attack complex) and coagulation cascades

       
     
  2. 2.

    Accelerated rejection

    1. a.

      Due to antibodies induced by the engrafted organ

       
    2. b.

      Occurs within the first 5 days

       
    3. c.

      Very rare in allogeneic transplantation

       
     
  3. 3.

    Acute rejection (most common type)

    1. a.

      Occur toward the end of the first week

       
    2. b.

      T-cell mediated

      1. i.

        CD4+ cells react with MHC antigens, then serve as the helper cells for CD8+ cells

         
      2. ii.

        CD8+ cells may be activated directly without CD4

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References

  1. Auchincloss H Jr, Sykes M, Sachs DH (1999) Transplantation Immunology. In: Paul WE (ed) Fundamental Immunology, 4th ed. Lippincott-Raven, Philadelphia, pp 1175–235Google Scholar

Copyright information

© Springer-Verlag 2004