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Pathology - Hyperacute Rejection of Transplant
This irreversible type II hypersensitivity reaction of preformed recipient alloantibodies to either the ABO blood group or HLA class I antigens on the graft endothelium occurs within minutes to maybe hours. The binding of the antibodies promotes release of particles that promote coagulation and cytokines that recruit inflammatory mediators. The graft tissue is destroyed through vascular thrombosis and rapid organ death as described in this patient. It is now rare due to good ABO screening and HLA crossmatching.
Patients who are most prone to have this occur are often listed with the highest priority for a graft. Preformed antibodies may result from many transfusions, several pregnancies, or prior transplants.
This irreversible type II hypersensitivity reaction of preformed recipient alloantibodies to either the ABO blood group or HLA class I antigens on the graft endothelium occurs within minutes to maybe hours. The binding of the antibodies promotes release of particles that promote coagulation and cytokines that recruit inflammatory mediators. The graft tissue is destroyed through vascular thrombosis and rapid organ death as described in this patient. It is now rare due to good ABO screening and HLA crossmatching.
Patients who are most prone to have this occur are often listed with the highest priority for a graft. Preformed antibodies may result from many transfusions, several pregnancies, or prior transplants.
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