What has a greater effect on infections/diseases post-organ transplant?

[Sir Salty]

Hey,

So for a essay I am writing I am discussing allotransplantation and its limitations and how xenotransplantation could potentially solve them. One limitation with allotransplantation is risk of infection due to exposure of donor/organ to the environment before the organ is transplanted. Another, of course, is side effects of immunosuppressants. I was wondering if anyone knows any sources where I can find data on which is more responsible for disease/infection after the transplant. I.e. how much does immunosupressants contribute and how much does epidemical reasons contribute? This would support that there are severe limits to allotransplantation however the screening of the animals and growing them in a controlled, sterile environment can help overcome risk of disease or infections as a result of the transplantation.

Thanks, any relevant information, links etc would be much appreciated. Or any key terms or technical phrases which could help me locate the information.

Also being very curious after writing 5000 words on the subject, what do you guys think about xenotransplantation specifically with "mixed chimerism"?

[Sir Salty]

Also could anyone explain why pancreas transplantation is rare and only occurs in patients with advance kidney disease? Why aren't many cases of diabeties 1 being cured by organ transplantation? I understand the risks involved with immunosuppressants, is this the only reason and if so do immunosuppressants have more severe side effects on diabetics? If not then what are the other limitations preventing allotransplantation from being a common practice to cure diabeties? If someone could respond as soon as possible as my paper is due on Wednesday. And could any information be linked with sources, thanks.

[Function]

Hey,

So for a essay I am writing I am discussing allotransplantation and its limitations and how xenotransplantation could potentially solve them. One limitation with allotransplantation is risk of infection due to exposure of donor/organ to the environment before the organ is transplanted. Another, of course, is side effects of immunosuppressants. I was wondering if anyone knows any sources where I can find data on which is more responsible for disease/infection after the transplant. I.e. how much does immunosupressants contribute and how much does epidemical reasons contribute? This would support that there are severe limits to allotransplantation however the screening of the animals and growing them in a controlled, sterile environment can help overcome risk of disease or infections as a result of the transplantation.

Thanks, any relevant information, links etc would be much appreciated. Or any key terms or technical phrases which could help me locate the information.

Also being very curious after writing 5000 words on the subject, what do you guys think about xenotransplantation specifically with "mixed chimerism"?

 

Don't forget the lack of immunocompatibility as a major problem in allotransplantation.

 

I don't think that immunosuppressants are as deadly as a septic shock due to cytokin storm in a potentially incompatible transplant: if you don't have anything else going on, you could miss your immune system for a while.

 

Lots of patients with lymphomas get immunosuppressants, suppressing the development/function of e.g. B-cells (in case of a B-cell lymphoma); they can do fine with it, but when they get a slightest fever, they better rush to emergency asap, since they don't have a functioning immune system against the threat.

 

What I mentioned about cytokin storm is a really nasty matter: when in a cytokin storm, dying isn't rare. Do some research on MHC, HLA, immunocompatibility etc.

 

---

 

Your comment on diabetes mellitus type 1 is interesting. But easily answered: the problem with DM-I is that your patient produces auto-antibodies against the pancreatic beta cells in the langerhans islets producing insulin. So whether it's your own pancreas or another pancreas you were to transplant, you're screwed and your beta cells will be destroyed (you could ask about the mediation of the destruction and immune response against the beta cells, but that is irrelevant: if you have your own autoreactive t cells reacting against your own pancreatic HLA-presenting beta cells, then you could ask yourself: transplanting someone else's pancreas doesn't express the same HLA; CAVE: this is immuno-incompatibility and - indifferent from the type of tissue (pancreatic) and its cells - will result in organ rejection.

 

I don't have the time to look up articles so you'll have to take my word for it - for what it's even worth.

 

Pancreas transplantations are not done. In case of DM-I, it's useless. In case of acute pancreatitis, you just have to watch 'n wait until it's over. In case of chronic pancreatitis, you could drain it and perform some surgical procedures (if interested, I know the next procedures: Partington-Rochelle drainage, Wirsung's procedure, Baker's procedure, Puestow's procedure; Puestow and Wirsung are not indicated anymore, however, in chronic pancreatitis; the drainage of Partington and Rochelle is the most commonly performed surgery in chronic pancreatitis).

Edited April 26, 2017 by Function

[CharonY]

One could also add that the donor may be infected. From what I understand e.g. toxoplasmosis is a significant issue.