Transplant

Anti rejection drugs

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Q) Anti Rejection medicine which also prevents tumor recurrence? MCH Questions ...

a) M tor inhibitors

b) IL2 blockers

c) Steroids

d) Azathioprine

Ans a) mtor inhibitors 

One Question is always asked about anti rejection medicines, Salient points i am enumerating

  1. Three drug regimen is classic includes IL2 blocker, Mycophenolate and steroids which are tapered . IL 2 blocker  Tacrolimus is used more than Cyclosporine ( cyclosporine less used now). IL2 blocker side effects are hirsutism, hyperkalemia, gum hypertrophy etc) 
  2. Mycophenolate is preferred over azathioprine . Both cause fall in cell lines
  3. Steroids have many side effects like weight gain, cataract, infections and are used in tapering dose

M-tor inhibitors are sirolimus and Everolimus which are used when transplant is done for HCC, IT has anti tumor action.

Immunosuppression

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Q) False regarding immunosuppresant medicines ?

a. MMF is a reversible inhibitor of IMD-DH
b. Both Cyclosporine  and tacrolimus inhibit NF-KB and its downstream effects
c. Everolimus acts on FKBP12To inhibit Calcineurin activity
d. ALG are more used in pancreas transplant

Ciclosporins

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Q) Not true about ciclosporin use in liver transplant

a) It exerts its effect the same way as tacrolimus

b) Nephrotoxicity is the main notable side effect

c) Both tacrlimus and ciclosporin have equal rates of preventing acute rejection

d) Hypetrension, DM and dyslipidemia are other common side effects

 

Allograft Rejection

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Q) Which of the following is false regarding HLA in graft rejection? 

a) HLA (Human leucocyte antigen) is the most common cause of graft rejection

b) They mainly serve as antigen recognition unit

c) HLA also serve as effector cells 

d) They are highly polymorphic

Pediatric liver transplant

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Q  ) Most common indication for Pediatric liver transplant (DNB SS) 
A. Biliary atresia
B. Metabolic diseases
C. Alagille syndrome
D. HCV

Free answer 

a 

Biliay atresia

MOst common cause or liver transplant in children.

Presents as persistent jaundice after birth. Etiology is not clear

Findings include absent extrahepatic ducts and gallbladder.

Biopsy is diagnostic

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