7 topics with concise reviews: definitions, key facts, and class questions.
This section is dedicated to the fundamentals of clinical transplantology. We examine the primary barriers to successful transplantation, first and foremost tissue incompatibility and the mechanisms of transplantation immunity development.
The material covers key methods for combating graft rejection: from total blood replacement to modern approaches of radiation, pharmacological, and biological immunosuppression. The practical part of the section details the surgical technique and topographic-anatomic aspects of vital organ transplantation — the kidney, liver, and heart.
In classes and exams, examiners most frequently ask about the types of vascular anastomoses in kidney transplantation (differences between orthotopic and heterotopic transplantation), the stages of donor heart and liver harvesting, and basic regimens for suppressing the immune response. Understanding these surgical and immunological principles is the key to successfully passing the topic.
Why did xenotransplantation of tissues from animals to humans in ancient times always end in failure?
Due to the insurmountable tissue barrier. The recipient's organism recognizes foreign graft antigens and triggers an immune response leading to its rejection and destruction.
Why is the method of total blood replacement not used in human organ transplantation?
In clinical practice, the procedure causes an extremely severe reaction in the recipient's body. Furthermore, it has been experimentally proven that it does not prevent the production of antibodies against the graft, and the organ rapidly fails.
What is the main goal of immunosuppressive therapy during transplantation?
The main objective is to suppress the activity of lymphoid tissue to reduce the reactivity of the immune system and prevent rejection of the transplanted organ.
What lies at the basis of the enhancement phenomenon?
The enhancement phenomenon is based on the action of humoral antibodies. An excess of antibodies or antigens blocks specific cell proliferation centers, leading to their death and the induction of tolerance.
Who performed the first successful kidney transplant and when?
The world's first transplantation was performed by Soviet surgeon Yu. Yu. Voronoy in 1934, although the organ failed to function. The first fully successful experience was an isotransplantation between identical twins performed by J. Murray in the USA in 1954.
What three main methods of liver transplantation are currently used?
Modern practice utilizes orthotopic transplantation (organ replacement), heterotopic transplantation (preserving the native liver while adding a donor liver), and temporary extracorporeal connection.
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