1. Transplant Immunology
Adi Alherbish

2. Outline Pre-sensitization: - B cells
Ischemia-reperfusion injury/ innate immune response:
- TLR
- Complement
- NK cells
Afferent arm:
- APC
- TH cells
Efferent arm:
- Cytopathic T cells, T-reg
- B cells, Plasma cells

3. Meet the Characters
Adkinson: Middleton's Allergy: Principles and Practice, 7th ed.

4. B cells

5. Sensitization Events
Exposure to non- self HLA antigens

8. Mature B cells
Memory B cells
Plasma cells

9. Methods of Antibody Detection
Clin J Am Soc Nephrol 1: 404–414, 2006

10. Luminex

11. Ischemia Reperfusion Injury

12. TLR
HSP-70
HSP-60
TEC
APCs

13. Immune Response to Post Ischemic Kidney
Jang et al, Clinical Immunology (2009) 130, 41–50

14. C3 wild type mice
C3 -/- deficient mice

16. B cell- mediated rejection
IRI

17. NK Cells Role in Acute and Chronic Allograft Rejection
IFG

18. HLA

19. MHC I:
Nucleated cells

20. MHC II:
B cells, APCs

21. Interferon
Endothelial cells
MHC I
MHC I
MHC II

22. Minor Histocombpatibility Antigens (miH)
MICA
MICB
located in close proximity to the HLA-B locus and encode for 62 kDa cell-surface glycoproteins which share limited sequence homologies with HLA class I molecules and are not associated with b2-microglobulin

23. T cells

24. T Lymphocytes Maturation in Thymus

25. Direct Allorecognition

26. Indirect Allorecogintion

27. Semi-direct Allorecognition

30. Calcium- Calcineurin Pathway

32. N Engl J Med Jun 18;338(25):

36. J Am Soc Nephrol 18: 2252–2261, 2007

38. Belatacept (CTLA-4- Ig)
N Engl J Med Jun 18;338(25):

39. +
Basiliximab
MMF
steroids

43. LFA-3–Ig, a dimeric fusion protein consisting of the CD2-binding portion of the human lymphocyte function-associated antigen-3 (LFA-3) linked to the Fc portion of human IgG1
complement-mediated lysis
interruption of CD2’s interactions with LFA-3
limiting helper T cell adhesion to antigen-presenting cells
disrupting the engagement of effector T cell receptor engagement with antigen and major histocompatibility complex molecules

45. Increased C5aR expression in TCMR infiltrating cells
Protocol Bx
IF/TA
Increased C5aR expression in TCMR infiltrating cells

46. Vehicle treated recipient
C5aRA
Increased apoptosis in control group 1 day after transplant