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Hypersensitivity and Kidney Transplant Rejection

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The immune system is an integral part of human protection against disease, but the normally protective immune system defenses can sometimes cause adverse reactions in the body. Such reactions are known as hypersensitivity reactions. The traditional classification for hypersensitivity reactions can be divided into the following four (4) types: (1) Type 1 reactions (ie, immediate hypersensitivity reactions) involve immunoglobulin E (IgE)-mediated release of histamine and other mediators from mast cells and basophils; (2) Type II reactions (ie, cytotoxic hypersensitivity reactions) involve immunoglobulin G or immunoglobulin M antibodies bound to cell surface antigens, with subsequent complement fixation; (3) Type III reactions (ie, immune-complex reactions) involve circulating antigen-antibody immune complexes that deposit in post-capillary venules, with subsequent complement fixation; and (4) Type IV reactions (ie, delayed hypersensitivity reactions, cell-mediated immunity) are mediated by T cells rather than antibodies. (Medscape, Immediate Hypersensitivity Reactions, np, 03/25/2014) Hypersensitivity can be associated to a number of immune system problems such as poison ivy reactions, reactions to transfusion of Type A blood with Type B blood, reaction to an exposure to a field of ragweed, and unsuccessful kidney transplant. In the case of kidney transplant there are three (3) types of rejection: hyperacute rejection, acute rejection, and chronic rejection. (Brown University, Transplant Rejection Therapy, np, nd) Each type of rejection is due to a type of hypersensitivity reaction. Hyperacute rejection occurs usually within the first twenty-four (24) hours after transplantation. This response occurs so quickly that the tissue never becomes vascularized. There are several explanations for the preexisting antibodies that initiate hyperacute rejection. (Brown

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