Info

Table 17.1. Classification of graft rejection

Type of Rejection

Time Frame

Mediators

Treatment

Hyperacute

Minutes to hours

Preformed antibodies

• Remove organ !!!!

Delayed Hyperacute

First few days following transplantation

Activators of endothelial cells; also pro-coagulants (including fibroleukin/fgl-2)

• Currently under investigation

Acute

Days to weeks

Cell mediated immunity

• Increase immunosuppression ( with caution)

Chronic

Months, to years

Multiple, likely nonspecific growth factorlike mediators (e.g., fibroblast growth factor; endothelial growth factor etc.) leading to an insidious fibrosing/proliferative reaction

• Does NOT respond to increased immunosuppression

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