1. Immunology of Renal Transplant
Ahmad Jaber ALMUJALHEM-K.U.B. R III-Academic Day 30th Jan 2014

2. Outline Immunology in Urology
Selection & Preparation of kidney transplant:
Recipient
Donor
RENAL ALLOGRAFT REJECTION
Classification of Rejection

3. Immunology in Urology Immunocompromised patient Auto Immune diseases
Wound healing and Immune system
Neoplasm and Immune system
Infection and Immune system
Infertility and Immune system
Vaccine
Immunotherapy
Immunosuppressant

4. Facts!

5. Facts!

6. SELECTION AND PREPARATION OF KIDNEY TRANSPLANT RECIPIENTS
Preliminary Screening
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7. Recipient
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10. Donor
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14. RENAL ALLOGRAFT REJECTION
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15. Histocompatibility ABO blood group
Major histocompatibility complex (MHC):
Class I antigens:
HLA-A, HLA-B & HLA-C
T lymphocytes
Class II antigens:
HLA-DR,HLA-DQ, HLA-DP
B lymphocytes, activated T lymphocytes, monocytes, macrophages,dendritic cells &some endothelial cells

18. Classification of Rejection
Hyperacute rejection:
Immediately after renal revascularization
Irreversible process
Mediated by preformed circulating cytotoxic antibodies
Accelerated rejection:
Mediated by humoral and cellular components
Within days to weeks
Does not respond to antirejection therapy.
Acute rejection (any time after transplantation)
Chronic rejection:
Gradual decline in renal function
Interstitial fibrosis
Vascular changes
Minimal mononuclear cell infiltration

19. http://www. intechopen

20. Nature Reviews Nephrology 8, 670-678 (November 2012) | doi:10
Nature Reviews Nephrology 8,   (November 2012) | doi: /nrneph

21. http://www. intechopen

22. symptoms of acute kidney transplant rejection
“the flu” accompanied by pain
Enlarged kidney graft
Hypertension
Decreased urinary output
Fluid retention
Increased serum creatinine levels

23. Dx
Needle biopsy of the kidney graft is the standard to confirm the diagnosis of acute rejection.
Typical histologic findings of acute renal allograft rejection:
Mononuclear cellular infiltration
Tubulitis
Vasculitis

24. Immunosuppression

28. Thanks
Question
Discussion