chronic rejection


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Related to chronic rejection: Acute Rejection

chron·ic re·jec·tion

a transplant rejection occurring gradually, sometimes months later.

rejection

Immunology An immune reaction evoked by allografted organs; the prototypic rejection occurs in renal transplantation, which is subdivided into three clinicopathologic stages. See Cyclosporin A, Graft rejection, Graft-versus-host disease, Second set rejection, Tacrolimus, Transplant rejection.
Rejection types  
Hyperacute rejection Onset within minutes of anastomosis of blood supply, which is caused by circulating immune complexes; the kidneys are soft, cyanotic with stasis of blood in the glomerular capillaries, segmental thrombosis, necrosis, fibrin thrombi in glomerular tufts, interstitial hemorrhage, leukocytosis and sludging of PMNs and platelets, erythrocyte stasis, mesangial cell swelling, deposition of IgG, IgM, C3 in arterial walls
Acute rejection Onset 2-60 days after transplantation, with interstitial vascular endothelial cell swelling, interstitial accumulation of lymphocytes, plasma cells, immunoblasts, macrophages, neutrophils; tubular separation with edema/necrosis of tubular epithelium; swelling and vacuolization of the endothelial cells, vascular edema, bleeding and inflammation, renal tubular necrosis, sclerosed glomeruli, tubular 'thyroidization' Clinical ↓ Creatinine clearance, malaise, fever, HTN, oliguria
Chronic rejection Onset is late–often more than 60 days after transplantation, and frequently accompanied by acute changes superimposed, increased mesangial cells with myointimal proliferation and crescent formation; mesangioproliferative glomerulonephritis, and interstitial fibrosis; there is in general a poor response to corticosteroids

chron·ic re·jec·tion

(kronik rē-jekshŭn)
Rejection of surgical transplant occurring gradually, sometimes months later.
References in periodicals archive ?
Moreover, two non-SVR patients developed chronic rejection related to HCV therapy, leading to graft failure and consequent retransplantation.
Hand transplants are currently monitored for chronic rejection with clinical and functional examinations, skin biopsies, donor specific antibody screening, and standard vascular imaging.
The major reasons for graft loss were immunological complications in fives cases (three patients with chronic rejection and two patients with acute rejection), vascular complications in four cases (three patients with venous thrombosis and one patient with arterial thrombosis), initial graft failure in four cases (defined as the need for postoperative dialysis), and one patient lost the graft because of the development of glomerulonephritis.
Erythrocytosis generally develops in those renal transplant recipients who have good renal function and without evidence of acute and chronic rejection.1 In our study PTE patients had excellent graft functions, with mean serum creatinine of 1.06+-0.29mg/dl at the onset of PTE.
The most profound barrier to pig-to-primate xenotransplantation is the rejection of the grafted organ by a cascade of immune mechanisms commonly referred to as hyperacute rejection (HAR), acute vascular rejection (AVR)/humoral xenograft rejection (AHXR), immune cell-mediated rejection, and chronic rejection. HAR leads to graft rejection within minutes, was considered as first barrier to pig-to-human xenotransplantation.
When present, many patients live the remaining years of their lives with chronic rejection if the process is finally arrested.
Early analysis indicates that this was secondary to severe chronic rejection restricted to the arteries of the allograft.
Endomyocardial biopsy and echocardiography were used to identify acute rejection, and we performed coronary angiography and, echocardiography when a recipient was hospitalized because of heart failure and chronic rejection. The standardized grading system for the pathologic diagnosis of rejection in cardiac biopsies and its revision were used to address a uniform description and grading scheme for acute cardiac rejection (11).
Three weeks before he died, the hospital rang to say John had chronic rejection of his new lungs and could slip away at any time.
"Chronic rejection set in and we decided to take Elizabeth home where she died after six months of intense care.
This leader's technical brilliance was equaled by his interest and accomplishment in setting the standards for modern day immunosuppression, allowing transplanted organs from unrelated donors to be accepted long-term without the ill consequences of immediate or chronic rejection. There was no question that this individual, who would be Dr.

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