1990 Heart transplant 1990 Terminally-ill journalist Adrian Sudbury is campaigning to educate young adults about what it means to be a bone marrow donor

Henry is interested in working with orthopedics, which includes limb reattachment. Marci wanted to understand why educated adults are not more interested in being organ donors.

 Blood type  Genetic markers  What kind of organ/tissue  Immunoglobulins IgG,IgM,IgA  Age and sex of the giver and receiver of certain organs. Immunosuppressant drugs can change everything!

 IgG:  2 identical Y chains  can pass through human placenta  Is a secondary immune response

 IgA:  H chain, J chain, L chain, secretory component  Mucosal immunity

 5 classes of immunosuppressant drugs 1)glucocorticoids 2)cytostatics 3)antibodies 4)drugs acting on immunophilins 5)other drugs5)other drugs.

 Used to prevent rejection of transplanted organs  Auto immune disease  Chronic anti-inflammatory

 Apheresis: the process by which plasma or cellular components are separated from the whole blood

 Plasmapheresis DFPP: apheresis used to remove blood plasma. In DFPP, plasma is separated with a plasma separator and passes through the plasma component separator with a small pore size. Large molecular-weight proteins are discarded and small molecular-weight substances including valuable albumin are returned to the patient. Small amount of substitution fluid such as albumin may be added.

 Plasma exchange: Plasma exchange involves replacing the plasma (the liquid part of a person’s blood) with plasma from a donor.

 In PA, plasma is separated with a plasma separator and flows into a plasma adsorption column.  Pathogenic substances are adsorbed and removed due to affinity between ligands and pathogenic substances. Note: Fluids are not replaced

 Patient 1  After three successive apheresis treatments  Vertical line after transplant occurs  Antibody production suppressed

 Patient 3  Received extended apheresis treatment  IgM shows typical response  IgG and IgA show increased immune response

 PA more consistent with each antibody type  IgM moves consistently with each apheresis method  IgG and IgA differ amongst apheresis types  PE clears IgG fastest, PA clears it slowest  DFPP clears IgA fastest, PA clears it slowest  Can customize apheresis method depending on patient’s condition

 Examines the effectiveness of certain immunosuppressive procedures  Enables clinicians to better categorize the patient’s response to implants  Enables clinicians to estimate antibody production during transplant procedures using algorithm

 No data post-operatively for the patient in figure 3.  Plasmapheresis used in unequal proportion compared to the two other methods of apheresis.  Limited sample size  Quantity and type of immunosuppressive drugs used was not recorded