BLOOD PHYSIOLOGY

Tissue and Organ Transplantation

By Dr. Mudassar Ali Roomi (MBBS, M. Phil.) Assistant Professor Physiology

 Organ transplantation is the moving of an organ from one body to another or from a donor site to another location on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ

Types of transplants: Autografts, Isografts,

Allografts, and Xenografts
A transplant of a tissue or whole organ from one part of the same animal to another part is called an autograft; from one identical twin to another, an isograft; From one human being to another or from any animal to another animal of the same species, an allograft e.g. kidney, heart, liver, glandular tissue, bone marrow, cornea of eye, and lung. And from a lower animal to a human being or from an animal of one species to one of another species, a xenograft.

Which type of graft is it?

Fight of immune system against transplantation

Autografts and isografts: no immune rejection allografts,: it should be done with proper HLA matching of tissues between persons. Immunosuppressant drugs are still required. many kidney allografts have been successful for at least 5 to 15 years, and allograft liver and heart transplants for 1 to 15 years. xenografts: immune reactions almost always occur, causing death of the cells in the graft within 1 day to 5 weeks after transplantation unless some specific therapy is used to prevent the immune reactions.

Tissue TypingThe HLA Complex of Antigens

The most important antigens for causing graft rejection are a complex called the HLA antigens. Six of these antigens are present on the tissue cell membranes of each person, but there are about 150 different HLA antigens to choose from. Therefore, this represents more than a trillion possible combinations. Consequently, it is virtually impossible for two persons, except in the case of identical twins, to have the same six HLA antigens. Development of significant immunity against any one of these antigens can cause graft rejection. The HLA antigens occur on the white blood cells as well as on the tissue cells.

 Therefore, tissue typing for these antigens is done on the membranes of lymphocytes that have been separated from the persons blood. The lymphocytes are mixed with appropriate antisera and complement; after incubation, the cells are tested for membrane damage. Some of the HLA antigens are not severely antigenic, for which reason a precise match of some antigens between donor and recipient is not always essential to allow allograft acceptance. Therefore, by obtaining the best possible match between donor and recipient, the grafting procedure has become far less hazardous. The best success has been with tissue-type matches between siblings and between parent and child. The match in identical twins is exact, so that transplants between identical twins are almost never rejected because of immune reactions.

Immunosuppressant drugs

Drawback of using immunosuppressant drugs

Increase risk of infections