Post-transplant - acute anti-body Treatment or prevention of graft rejection where The second indication has been amended to mediated rejection with clinical conventional immunosuppressive therapies is more accurately reflect the fact that clinical evidence of graft dysfunction is not always evidence of graft dysfunction contraindicated or pose a threat to the graft or patient required - a one-off request may be approved in the early period of rejection where there is Treatment or prevention of graft a high clinical suspicion. The criteria rejection where conventional themselves have not changed and this change immunosuppressive therapies is is consistent with Kidney transplantation. contraindicated or pose a threat to the graft or patient Transplant rejection occurs when a In heart transplant, the approach to desensitise A short description relating to desensitisation Description recipient’s immune system attacks a patients is reasonably common because of the and has been added. transplanted organ or tissue. Despite increasing use of device technology (and exposure Diagnostic the use of immunosuppressants, one or to blood transfusion), so there is an increasing Criteria more episodes of rejection can occur population of sensitised patients that would not be after transplantation. Both cellular and considered for transplant without this approach. humoral (antibody-mediated) effector Desensitisation is only an occasional occurrence in mechanisms can play a role. lung transplantation. The presence and pattern of rejection Transplant rejection occurs when a recipient’s need to be established by biopsy. immune system attacks a transplanted organ or Laboratory tests to assess the presence tissue. Despite the use of immunosuppressants, and strength of antibodies to the donor one or more episodes of rejection can occur after antigens can provide additional useful transplantation. Both cellular and humoral information. Clinical assessment, blood (antibody-mediated) effector mechanisms can play tests, ultrasound and nuclear imaging a role. are used primarily to exclude other The presence and pattern of rejection need to be causes of organ dysfunction. established by biopsy. Laboratory tests to assess Acute cellular rejection occurs in the presence and strength of antibodies to the of organ transplants and is donor antigens can provide additional useful responsive to steroids in more than 90% information. Clinical assessment, blood tests, of cases. When rejection is steroid
Post-transplant - acute anti-body mediated rejection with clinical evidence of graft dysfunction Treatment or prevention of graft rejection where conventional immunosuppressive therapies is contraindicated or pose a threat to the graft or patient Treatment or prevention of graft rejection where conventional immunosuppressive therapies is contraindicated or pose a threat to the graft or patient The second indication has been amended to more accurately reflect the fact that clinical evidence of graft dysfunction is not always required - a one-off request may be approved in the early period of rejection where there is a high clinical suspicion. The criteria themselves have not changed and this change is consistent with Kidney transplantation. Description and Diagnostic Criteria Transplant rejection occurs when a recipient’s immune system attacks a transplanted organ or tissue. Despite the use of immunosuppressants, one or more episodes of rejection can occur after transplantation. Both cellular and humoral (antibody-mediated) effector mechanisms can play a role. The presence and pattern of rejection need to be established by biopsy. Laboratory tests to assess the presence and strength of antibodies to the donor antigens can provide additional useful information. Clinical assessment, blood tests, ultrasound and nuclear imaging are used primarily to exclude other causes of organ dysfunction. Acute cellular rejection occurs in of organ transplants and is responsive to steroids in more than 90% of cases. When rejection is steroid In heart transplant, the approach to desensitise patients is reasonably common because of the increasing use of device technology (and exposure to blood transfusion), so there is an increasing population of sensitised patients that would not be considered for transplant without this approach. Desensitisation is only an occasional occurrence in lung transplantation. Transplant rejection occurs when a recipient’s immune system attacks a transplanted organ or tissue. Despite the use of immunosuppressants, one or more episodes of rejection can occur after transplantation. Both cellular and humoral (antibody-mediated) effector mechanisms can play a role. The presence and pattern of rejection need to be established by biopsy. Laboratory tests to assess the presence and strength of antibodies to the donor antigens can provide additional useful information. Clinical assessment, blood tests, A short description relating to desensitisation has been added.
Solid-organ-transplantation-other-than-kidney2017.docx