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Pathology · USMLE Step 1

USMLE Pathology: Transplant and Rejection

Transplant rejection types and graft-versus-host disease morphology, one finding per card.

35 cards · basic cards · AI-written, checked twice. Edit anything.

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What is the timing of hyperacute transplant rejection after revascularization?
Minutes to hours
What causes hyperacute rejection?
Preformed antidonor antibodies already present in the recipient
What type of hypersensitivity reaction is hyperacute rejection?
Type II hypersensitivity
What happens when preformed antibodies bind donor endothelium in hyperacute rejection?
Complement activation, causing endothelial damage
What is the characteristic finding in hyperacute rejection?
Widespread thrombosis of graft vessels
Why does a hyperacutely rejected graft need to be removed?
It never becomes vascularized and undergoes ischemic necrosis
What pretransplant test prevents hyperacute rejection?
Crossmatch testing for preformed antidonor antibodies
What is the typical timing of acute transplant rejection?
Weeks to months after transplant
What are the two mechanisms of acute transplant rejection?
Cellular (T cell-mediated) and humoral (antibody-mediated)
Which immune cells mediate acute cellular rejection?
CD8+ cytotoxic T cells
What do CD8+ T cells target in acute cellular rejection?
Donor MHC antigens on graft cells
What histologic finding characterizes acute cellular rejection?
Dense interstitial lymphocytic infiltrate
What is tubulitis, seen in acute cellular rejection of a kidney transplant?
Lymphocytes invading and damaging the renal tubular epithelium
What vascular finding is seen in acute cellular rejection?
Endothelialitis, lymphocytes beneath the vascular endothelium
What mediates acute humoral (antibody-mediated) rejection?
Antidonor antibodies plus complement activation against graft vasculature

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