acute rejection


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a·cute cel·lu·lar re·jec·tion

graft rejection that usually begins within 10 days after a graft has been transplanted into a genetically dissimilar host. Lesions at the site of the graft characteristically are infiltrated with large numbers of lymphocytes and macrophages that cause tissue damage. See: primary rejection.
Synonym(s): acute rejection

acute rejection

Etymology: L, rejicere, to throw back
after organ transplantation, the rapid reaction against allograft or xenograft tissue that is incompatible. It often occurs a week after treatment, during which the immune response increases in intensity.

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

acute rejection

The early destruction of grafted or transplanted material, usually beginning a week after implantation. Acute rejection is identified clinically by decreased function of the transplanted organ. High-dose corticosteroids are the first treatment of acute rejection; they are typically quite effective. Antilymphocyte globulin (ALG), the monoclonal antibody OKT 3, mycophenolate mofetil, and tacrolimus are used when corticosteroids are not effective. See: suppressive immunotherapy; macrophage processing; major histocompatibility complex; T cell
See also: rejection
References in periodicals archive ?
Three variables for monitoring graft loss were identified from the primary aim of this study: medication nonadherence, acute rejection, and change in kidney function.
Finally, it has been suggested that CMV infection/disease and acute rejection are associated with reduced renal function.
Secondly, much higher doses of immunosuppressant are needed to prevent acute rejection given the composite nature of the hand allograft, thereby inhibiting subacute rejection episodes needed to kill donor SCs and stimulate migration of host SCs into the graft.
Cox proportional hazard regression analysis showed higher preoperative creatinine level, acute rejection, early postoperative functional status and unsatisfactory rejection surveillance protocol in the first 6 months after transplantation were prominent factors associated with the long-term survival (Table 6, Fig.
Acute rejection, described previously, may occur at any time, although the majority of episodes occur within the first year (Figure 5).
Supplemental therapy with steroids in settings of stress or acute rejection often involves methylprednisolone 15 mg/kg intravenously daily for 3 consecutive days, then a return to the previous prednisone dose.
Thymoglobulin, which was introduced to the US market in 1999, is a pasteurized anti-thymocyte rabbit immunoglobulin indicated for the treatment of renal transplant acute rejection, in conjunction with concomitant immunosuppression.
Acute rejection: Despite compliance with medication and immunosuppressant therapy, 35 percent of transplant recipients experience acute rejection.
Protein Design plans to develop its SMART Anti-CD3 antibody for the treatment of acute rejection in organ transplantation and for treatment of certain autoimmune diseases.
Cyclosporine withdrawal has not been studied in patients who have had severe acute rejection prior to cyclosporine withdrawal, those who require dialysis or have a high serum creatinine, Black patients, patients receiving a repeat kidney transplant, patients receiving other transplanted organs besides the kidney transplant, or patients with antibodies that may be directed against the kidney transplant.
Healthcare company Sanofi (NYSE:SNY) disclosed on Monday the receipt of approval from the US Food and Drug Administration (FDA) for Thymoglobulin [anti-thymocyte globulin (rabbit)] for use in conjunction with concomitant immunosuppression in the prophylaxis, or prevention, of acute rejection in patients receiving a kidney transplant.

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