II. Types: Hyperacute Graft Rejection

  1. Onset within hours to days of Transplantation
  2. Caused by pre-existing host Antibody (inadequately cross-matched graft)
    1. ABO Incompatibility (Blood Transfusion Reaction)
    2. HLA incompatibility
  3. Mechanism
    1. Antibodies bind graft endothelium, activating complement
    2. Endothelial inflammation and ultimately graft thrombosis results

III. Types: Acute Graft Rejection

  1. Onset within days to weeks of Transplantation
  2. Mechanism
    1. CD8+ T Cell activation and graft destruction
    2. Monocyte activation (by T Cells) results in delayed type Hypersensitivity
    3. B-Cell Antibody production against graft vessel wall Antigens

IV. Types: Chronic Graft Rejection

  1. Onset within months to years of Transplantation
  2. Mechanism
    1. Immune response with graft chronic inflammation
    2. Results in vessel intimal thickening and gradual vessel narrowing (Arteriosclerosis) to Occlusion

V. Types: Graft Versus Host Disease (GVHD)

  1. Mechanism
    1. Donor transplant contains T-Cells that react against the recipient's host Antigens
    2. Results in inflammatory cascade with risk of Graft Rejection
  2. Subtypes
    1. Acute Graft Versus Host Disease
      1. Onset <100 days post-Transplantation
    2. Chronic Graft Versus Host Disease
      1. Onset >100 days post-Transplantation
      2. More prolonged course that may persist years
  3. Symptoms (vary by severity, organ)
    1. Nausea and Vomiting
    2. Diarrhea
    3. Jaundice
    4. Skin Rash

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Related Studies

Ontology: Graft Rejection (C0018129)

Definition (NCI) Failure of transplanted tissue to become functional or operational, often as a result of destruction by the host's immune system.
Definition (MSH) An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient.
Definition (CSP) cell-mediated immune response by the host body to a surgically grafted organ or tissue that results in failure of the organ or tissue to survive; can be acute or chronic.
Concepts Organ or Tissue Function (T042)
MSH D006084
SnomedCT 20525008, 72627004, 213148006
English Graft Rejections, Rejection, Graft, Rejections, Graft, Rejection, Transplant, Rejection, Transplantation, Rejections, Transplant, Rejections, Transplantation, TRANSPLANT REJECTION, Transplant Rejection, Transplant Rejections, Transplantation Rejection, Transplantation Rejections, Graft Rejection, TRANSPL REJECTION, REJECTION TRANSPL, transplant rejection, graft rejections, transplantation rejection, rejection transplant, transplant rejections, rejection graft, graft rejection, Transplant rejections, Transplant failure due to rejection, Graft rejection, Transplant rejection, Cellular graft rejection, Graft rejection (finding), Immunologic graft rejection, rejection; transplant, transplant; rejection, Cellular graft rejection, NOS, Graft rejection, NOS, Immunologic graft rejection, NOS
German TRANSPLANTATABSTOSSUNG, Transplantatabstossung, Transplantatabstossungen, Abstoßung, Transplantat-, Transplantatabstoßung
Italian Rigetti di trapianto, Rigetto di trapianto, Rigetto di innesto, Rigetto del trapianto
Dutch transplantaatafstoting, afstoten; transplantaat, transplantaat; afstoting, transplantaat afstoting, transplantaatafstotingen, Afstoting van transplantaat, Transplantaat, afstoting van
Portuguese Rejeição de enxerto, REGEICAO DE TRANSPLANTE, Rejeição de transplantações, Rejeição de transplante, Rejeição de Enxerto, Rejeição de Transplante
Spanish Rechazo de injerto, rechazo del trasplante, fracaso del trasplante secundario a rechazo, rechazo celular del injerto, rechazo del injerto (hallazgo), rechazo del injerto, rechazo inmunológico del injerto, Rechazo de transplantes, Rechazo de trasplante, Rechazo de Injerto, Rechazo de Trasplante
Japanese 移植片拒絶反応, 移植拒絶反応, イショクキョゼツハンノウ, イショクヘンキョゼツハンノウ, 移植拒絶, 移植片拒絶, 拒絶反応, 移植片拒否, 移植片拒否反応
Swedish Transplantatavstötning
Czech štěp - vypuzení, Rejekce transplantátu, Rejekce štěpu, Odhojení transplantátu, štěp - odhojení, odhojení transplantátu, odhojování transplantátu, rejekce transplantátu, odmítnutí transplantátu, rejekce štěpu, odmítnutí štěpu, štěp - rejekce, odhojování štěpu, odhojení štěpu
Finnish Hyljintä
French Rejet de transplantation, Rejet du transplant, REJET DE GREFFE, Rejet du greffon, Rejet de greffe, Rejets de greffe
Polish Odrzucanie przeszczepu
Hungarian Transzplantátum kilökődések, Transplantatum rejectio, Graft rejectio
Norwegian Transplantatrejeksjon, Transplantatforkastelse, Transplantatavstøtning

Ontology: Graft-vs-Host Disease (C0018133)

Definition (NCI_NCI-GLOSS) A disease caused when cells from a donated stem cell graft attack the normal tissue of the transplant patient. Symptoms include jaundice, skin rash or blisters, a dry mouth, or dry eyes.
Definition (NCI) An incompatibility reaction (which may be fatal) in a subject (host) of low immunological competence (deficient lymphoid tissue) who has been the recipient of immunologically competent lymphoid tissue from a donor who lacks at least one antigen possessed by the recipient host; the reaction, or disease, is the result of action of the transplanted cells against those host tissues that possess the antigen not possessed by the donor. Seen most commonly following bone marrow transplantation, acute disease is seen after 5-40 days and chronic disease weeks to months after transplantation, affecting, principally, the gastrointestinal tract, liver, and skin.
Definition (MSH) The clinical entity characterized by anorexia, diarrhea, loss of hair, leukopenia, thrombocytopenia, growth retardation, and eventual death brought about by the GRAFT VS HOST REACTION.
Definition (CSP) caused by immunologically competent T cells in the graft recognizing and attacking host tissues as foreign; clinical symptoms include skin rashes, diarrhea, and abnormal liver functions.
Concepts Disease or Syndrome (T047)
MSH D006086
ICD9 279.5, 279.50
ICD10 D89.813 , D89.81
SnomedCT 75744002, 234646005
English Disease, Graft-Versus-Host, Disease, Graft-vs-Host, Disease, Homologous Wasting, Disease, Runt, Diseases, Graft-Versus-Host, Diseases, Graft-vs-Host, Graft vs Host Disease, Graft-Versus-Host Disease, Graft-Versus-Host Diseases, Graft-vs-Host Disease, Graft-vs-Host Diseases, Homologous Wasting Disease, Runt Disease, GRAFT VERSUS HOST DISEASE, GVHD, GVHD-Graft-versus-host disease, GRAFT VS HOST DIS, HOMOL WASTING DIS, RUNT DIS, GRAFT VERSUS HOST DIS, autoimmune foreign transplant disease, graft-versus-host disease (diagnosis), graft-versus-host disease, GVHD (graft-versus-host disease), Graft-versus-host disease <GVHD>, GVH disease, Graft-versus-host NOS, Graft-versus-host disease, unspecified, Graft vs Host Disease [Disease/Finding], disease graft host versus, gvh, graft vs host disease, graft-versus-host diseases, gvh disease, disease graft host vs, gvhd, disease graft versus host, host vs graft disease, graft-vs-host disease, Graft versus host disease (disorder), Graft-versus-host disease, GVHD - Graft-versus-host disease, Graft versus host disease, Graft-versus-host disease (disorder), graft versus host disease, host versus graft disease, Graft versus host disease, NOS, Runting syndrome, Graft versus host disease [Ambiguous], Graft Versus Host Disease, Graft Vs. Host Disease, Graft-Versus-Host-Disease, homologous wasting disease, runt disease
Italian Malattia del trapianto contro l'ospite, Reazione del trapianto contro l'ospite, Reazione del trapianto verso l'ospite, GVHD, Malattia del rigetto verso l'ospite, Malattia da rigetto di trapianto d'organo
Dutch graft-versus-host-ziekte (GVH ziekte), graft-versus-host-ziekte, Graft versus Host-ziekte, GvH ziekte, Ziekte, Graft versus Host-
French RGCH, Maladie homologue, MALADIE DU GREFFON CONTRE L'HOTE, Maladie du greffon contre l'hôte, Maladie des rabougris
German GVHD, chronisches GVH Syndrom <GVHD>, GVH Syndrom, Graft versus Host Syndrom, Graft-versus-host-Krankheit, Graft-versus-host-reaction, Homologous Wasting Disease, Runt-Disease
Spanish Enfermedad del injerto frente al huesped (EIFH), EICH, Enfermedad ICH, rechazo de injerto contra huésped, enfermedad de injerto versus huésped (trastorno), GVHD, enfermedad de injerto versus huésped, enfermedad de injerto contra huésped (trastorno), enfermedad de injerto contra huésped, enfermedad del injerto contra el huésped, enfermedad del injerto contra el huésped (concepto no activo), reacción de injerto contra huésped, rechazo injerto contra huésped, Enfermedad del injerto contra el huésped, Enfermedad de Rechazo, Enfermedad Runt, Enfermedad Injerto contra Huésped
Japanese GVHD, GVH病, GVHビョウ, イショクヘンタイシュクシュビョウ, GVHD, 移植片対宿主病, 移植片-対宿主病, ラント病, 同種移植消耗病, 移植片宿主相関病, 移植片対宿主疾患, 移植片対宿主相関病, 対宿主性移植片病
Swedish Transplantat-mot-värdsjukdom
Czech GVHD, graft vs host nemoc, Reakce štěpu proti hostiteli <GVHD>, Reakce štěpu proti hostiteli, Reakce GVH (reakce štěpu proti hostiteli), nemoc z reakce štěpu proti hostiteli, nemoc příjemce po transplantaci, nemoc štěpu proti hostiteli
Finnish Graft versus host -sairaus
Portuguese DOENCA DO ENXERTO CONTRA O HOSPED, Doença de enxerto contra hospedeiro, Doença de Perda, Doença do Definhamento Homólogo, Doença Enxerto-Hospedeiro
Polish Choroba przeszczep przeciw gospodarzowi, Choroba charłacza
Hungarian GVH betegség, Graft versus host betegség, Graft-versus-host betegség <GVHD>, GVHD
Norwegian Transplantat-mot-vert-sykdom, GVH-reaksjon, Graft-versus host reaksjon

Ontology: Hyperacute graft rejection (C0301947)

Concepts Pathologic Function (T046)
SnomedCT 26522000
English Accelerated graft rejection, Antibody-mediated graft rejection, Humoral graft rejection, Hyperacute graft rejection, Humoural graft rejection, Hyperacute graft rejection (finding)
Spanish rechazo acelerado del injerto, rechazo del injerto mediado por anticuerpos, rechazo hiperagudo del injerto (hallazgo), rechazo hiperagudo del injerto, rechazo humoral del injerto

Ontology: Chronic graft rejection (C0301948)

Concepts Pathologic Function (T046)
SnomedCT 8729004
English Chronic graft rejection (finding), Chronic graft rejection, Chronic graft rejection, NOS
Spanish rechazo crónico del injerto (hallazgo), rechazo crónico del injerto

Ontology: Transplanted organ rejection (C0345468)

Concepts Pathologic Function (T046)
SnomedCT 157792003, 213148006
English organ transplant rejection, organ rejection transplants, organs rejection transplanted, transplanted organ rejection, Transplanted organ rejection, Transplanted organ rejection (disorder)
Spanish rechazo de órgano trasplantado (trastorno), rechazo de órgano trasplantado

Ontology: Acute Rejection (C3273245)

Definition (NCI) Rejection of a transplanted organ that usually occurs after the first week of the transplantation. The risk of acute rejection is highest in the first three months following transplantation. Morphologically, there is an inflammatory infiltrate composed of lymphocytes and neutrophils and vascular damage in the rejected tissue.
Concepts Finding (T033)
English Acute Rejection