Homologous wasting disease
Overview
In most transplants, the patient's body may attempt to reject the transplanted organ (transplant rejection). However, in GVHD, the reverse happens; immune cells from the transplant attack the patient's cells.
Symptoms
* Painful rash * Itchy rash * Fever * Jaundice * Coma * Pain * Photophobia * Wheezing * Dyspnoea * Shortness of breath
Causes
The donated organ, called an allograft if the donor and recipient are unrelated, is transplanted into the recipient, called the host. Rejection can occur when the host’s immune responses are directed against the graft. The rapidity and reversibility of rejection depend on the various mechanisms involved, such as peritransplant ischemia and mechanical trauma, preformed antibody interactions with graft antigens, alloantigen-reactive T cells, and abnormal tissue remodeling. Graft rejection syndromes can be divided into three subtypes, based on timing of onset and mechanisms involved.
Treatment
Management of transplant patients involves postoperative care after transplantation, close monitoring of the function of the grafted organ, immunosuppressive therapy for prevention and control of acute rejection, and surveillance with prophylactic measures against opportunistic infections. The primary method for managing hyperacute rejection is prevention. Avoidance of high-risk donor-recipient combinations and the use of thorough pretransplant screening for cross-reactive antibodies are important. When a hyperacute rejection reaction is initiated, no pharmacologic agents can halt it. Management becomes supportive until another donor organ can be found. In acute rejection, immunosuppressants, usually given in combination regimens, can be effective. Commonly used agents include corticosteroids, cyclosporine, tacrolimus, and azathioprine. Newer antirejection therapies such as muromonab-CD3, an immunosuppressive monoclonal antibody directed at the CD3 molecule on T cells, are promising. There’s no accepted therapeutic strategy for treating chronic rejection. Preventive strategies to minimize peritransplant ischemia and reperfusion injury are under investigation and include such measures as the use of pulsatile graft perfusion devices during transport and peritransplant graft treatments to minimize release of mediators in response to vascular trauma. Clinical tip Because graft rejection can be compounded by coexisting opportunistic infections, prophylaxis and early antibiotic or antiviral interventions are commonly indicated.
Resources
The following terms can be used for Homologous wasting disease * graft versus host disease Source: CRISP