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the development of chronic rejection. In particular, the incidence increases following severe or persistent acute rejection, whereas acute rejection episodes with return to function back to baseline do not have major effects on graft survival. Chronic rejection is generally thought of as being related to either vascular damage or parenchymal damage with subsequent fibrosis. While it is unknown the exact contribution of the immune system in these processes, the indirect pathway of allorecognition and the associated antibody formation seems to be especially involved.
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181:. In humans, this is known as the human leukocyte antigen (HLA) system and over 17,000 HLA alleles or genetic variants have been described such that it is extremely uncommon for any two people to have identical alleles. Other non-HLA proteins, known as minor histocompatibility antigens, do exist but generally are unable to cause acute rejection in and of themselves unless a multitude of non-HLA proteins are mismatched. As such, HLA matching (in addition to matching ABO groups) is critical in preventing acute rejection.
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messages exchanged with a care team. Patients completing the study achieved a 90.1% adherence rate. The researchers noted that further randomized trials are required to confirm the initial findings. However, the results were very promising considering few options exist to support pediatric patients in taking their medications.
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Barring genetically identical twins, acute rejection is to be expected to some degree. Rates of clinically significant acute rejection that could endanger transplant have decreased significantly with the development of immunosuppressive regimens. Using kidney transplants as an example, rates of acute
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antigens. Consequently, transplants between individuals with differing ABO blood types is generally avoided though may be pursued in very young children (generally under 12 months, but often as old as 24 months) who do not have fully developed immune systems. Shortages of organs and the morbidity and
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to recruit more lymphocytes as well as cause apoptosis or cell death directly. The greater the difference in MHC between donor and recipient, the more cytotoxic T-cells are recruited to damage the graft, which may be seen via biopsy in solid organ transplants, with increased lymphocyte infiltration
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come across peptides from donor tissue whether in circulation, lymphoid tissue, or in donor tissue itself. Since not the result of direct antigen presentation, these may not necessarily be intact MHC molecules but instead other proteins that are deemed different enough from recipient may engender a
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Graft failure secondary to hyperacute rejection has significantly decreased in incidence as a result of improved pre-transplant screening for antibodies to donor tissues. While these preformed antibodies may result from prior transplants, prior blood transfusions, or pregnancy, hyperacute rejection
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is an insidious form of rejection that leads to graft destruction over the course of months, but most often years after tissue transplantation. The mechanism for chronic rejection is yet to be fully understood, but it is known that prior acute rejection episodes are the main clinical predictor for
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Hyperacute rejection manifests severely and within minutes, and so treatment is immediate: removal of the tissue. Acute rejection is treated with one or several of a few strategies. Despite treatment, rejection remains a major cause of transplant failure. Chronic rejection is generally considered
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is another method that can be used. In this method, the genes that cause the body to reject transplants would be deactivated. Research is still being conducted, and no gene therapies are being used to date to treat patients. Current research tends to focus on Th1 and Th17 which mediate allograft
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studied the acceptability and feasibility of an asynchronous directly observed therapy mobile health application among adolescent heart transplant recipients. Patients in the study utilized emocha Health's digital medication adherence program which included asynchronous video messages and chat
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Chronic rejection has widely varied effects on different organs. At 5 years post-transplant, 80% of lung transplants, 60% of heart transplants and 50% of kidney transplants are affected, while liver transplants are only affected 10% of the time. Therefore, chronic rejection explains long-term
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response. This process leads to the priming of T-cells to respond to the peptides secondarily going forward. A third semi-direct pathway has been described in which recipient APCs present fully intact donor MHCs, yet its relative contribution to acute rejection is not as well understood.
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is a category of rejection that occurs on the timescale of weeks to months, with most episodes occurring within the first 3 months to 1 year after transplantation. Unlike hyperacute rejection, acute rejection is thought to arise from two distinct immunological mechanisms as
365:, particularly in telltale ratios, (2) structural compromise of tissue anatomy, varying by tissue type transplanted, and (3) injury to blood vessels. Tissue biopsy is restricted, however, by sampling limitations and risks/complications of the invasive procedure. Cellular
234:. These helper T-cells have a crucial role in the development of B-cells that can create donor-specific antibodies. The antibodies deposit themselves within the donor graft and lead to activation of the complement cascade alongside antibody-mediated cytotoxicity with
312:, which proliferate and secrete proteins forming scar tissue. A similar phenomenon can be seen with liver transplant wherein fibrosis leads to jaundice secondary to the destruction of bile ducts within the liver, also known as vanishing bile duct syndrome.
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Transplant rejection can be classified into three types: hyperacute, acute, and chronic. These types are differentiated by how quickly the recipient's immune system is activated and the specific aspect or aspects of immunity involved.
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This process of recognition by T-cells can happen directly or indirectly and lead to acute cellular and acute humoral rejection respectively. Direct allorecognition is a phenomenon within transplant immunology where the
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rejection have declined from >50% in the 1970s to 10-20%. Singular episodes of acute rejection, when promptly treated, should not compromise transplant; however, repeated episodes may lead to chronic rejection.
136:. Irreversible damage via thrombosis and subsequent graft necrosis is to be expected. Tissue left implanted will fail to work and could lead to high fever and malaise as the immune system acts against foreign tissue.
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One principal reason for transplant rejection is non-adherence to prescribed immunosuppressant regimens. This is particularly the case with adolescent recipients, with non-adherence rates near 50% in some instances.
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Cases refractory to immunosuppressive or antibody therapy are sometimes treated with photopheresis, or extracorporeal photoimmune therapy (ECP), to remove antibody molecules specific to the transplanted tissue.
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morbidity in most lung-transplant recipients, the median survival roughly 4.7 years, about half the span versus other major organ transplants. Airflow obstruction not ascribable to other cause is labeled
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Chang YC (2021-01-01). "The surgical and immunosuppressive basis for infections in the pediatric solid organ transplant recipient". In
Steinbach WJ, Green MD, Michaels MG, Danziger-Isakov LA (eds.).
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and present their MHC peptides to recipient lymphocytes. In comparison, indirect allorecognition is more analogous to how foreign antigens are recognized by the immune system. Dendritic cells of the
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Jaramillo A, Fernández FG, Kuo EY, Trulock EP, Patterson GA, Mohanakumar T (February 2005). "Immune mechanisms in the pathogenesis of bronchiolitis obliterans syndrome after lung transplantation".
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in the donor organ. These antigens are located on the endothelial lining of blood vessels within the transplanted organ and, once antibodies bind, will lead to the rapid activation of the
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100:, which destroys the transplanted tissue. Transplant rejection can be lessened by determining the molecular similitude between donor and recipient and by use of
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indicative of more severe acute cellular rejection. Acute humoral rejection is a process usually initiated by indirect allorecognition arising from recipient
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A pilot study conducted by
Michael O. Killian PhD from Florida State University and Dr. Dipankar Gupta from University of Florida published in April 2022 in
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1619:
Srinivas TR, Schold JD, Meier-Kriesche HU (2010-01-01). "Chapter 105 - Outcomes of Renal
Transplantation". In Floege J, Johnson RJ, Feehally J (eds.).
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571:, once used to prevent rejection, and still occasionally used to treat severe acute rejection, has fallen into disfavor, as it commonly brings severe
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mortality associated with being on transplant waitlists has also increased interest in ABO-incompatible transplantation in older children and adults.
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can replace the transplant recipient's immune system with the donor's, and the recipient accepts the new organ without rejection. The marrow's
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1603:
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Gautreaux MD (2017-01-01). "Chapter 17 - Histocompatibility
Testing in the Transplant Setting". In Orlando G, Remuzzi G, Williams DF (eds.).
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is a form of rejection that manifests itself in the minutes to hours following transplantation. It is caused by the presence of pre-existing
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Menon MC, Cravedi P, El Salem F (2017-01-01). "Chapter 32 - Acute
Cellular Rejection". In Orlando G, Remuzzi G, Williams DF (eds.).
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for "IMAGE: A Comparison of AlloMap
Molecular Testing and Traditional Biopsy-based Surveillance for Heart Transplant Rejection" at
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HĂĽbscher SG, Clouston AD (January 2012). "Chapter 15 - Transplantation pathology". In Burt AD, Portmann BC, Ferrell LD (eds.).
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173:, a subset of white blood cells, begin to recognize antigens on transplanted organ/graft. This recognition occurs due to the
19:"Host-versus-graft disease" redirects here. For the condition in which transplanted cells attack the recipient's cells, see
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Diagnosis of acute rejection relies on clinical data—patient signs and symptoms but also calls on laboratory data such as
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2019:
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Frenet EM, Scaradavou A (2019-01-01). "Chapter 32 - Human
Leukocyte Antigens". In Shaz BH, Hillyer CD, Gil MR (eds.).
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Killian, Michael O.; Clifford, Stephanie; Lustria, Mia Liza A.; Skivington, Gage L.; Gupta, Dipankar (2022-04-18).
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Dharnidharka VR (2019-01-01). "Chapter 43 - Pediatric Renal
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irreversible and poorly amenable to treatment—only retransplant generally indicated if feasible—though inhaled
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Yuan X, Paez-Cortez J, Schmitt-Knosalla I, D'Addio F, Mfarrej B, Donnarumma M, et al. (December 2008).
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West LJ, Pollock-Barziv SM, Dipchand AI, Lee KJ, Cardella CJ, Benson LN, Rebeyka IM, Coles JG (March 2001).
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Harmon WE (2010-01-01). "Chapter 41 - Pediatric Renal
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Dharnidharka VR (2019-01-01). "43 - Pediatric Renal
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2075:"19F MRI detection of acute allograft rejection with in vivo perfluorocarbon labeling of immune cells"
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Subramanian V, Ramachandran S, Klein C, Wellen JR, Shenoy S, Chapman WC, Mohanakumar T (August 2012).
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1964:"Directly observed therapy to promote medication adherence in adolescent heart transplant recipients"
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1917:"Should we retransplant a patient who is non-adherent? A literature review and critical reflection"
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1797:"Course of FEV(1) after onset of bronchiolitis obliterans syndrome in lung transplant recipients"
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238:, a type of white blood cell separate from lymphocytes, predominantly infiltrating into tissues.
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160:
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Naesens M, Kuypers DR, De Vusser K, Evenepoel P, Claes K, Bammens B, et al. (August 2014).
1536:"Long-Term Outcomes after Acute Rejection in Kidney Transplant Recipients: An ANZDATA Analysis"
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Antibody specific to select immune components can be added to immunosuppressive therapy. The
177:(MHC), which are proteins on cell surface that are presented to the T-cell receptor found on
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Acute cellular rejection occurs following direct allorecognition of mismatched donor MHC by
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2349:"A novel role of CD4 Th17 cells in mediating cardiac allograft rejection and vasculopathy"
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Vitak K (2014-01-01). "Chapter 14 - Organ Transplantation". In Paz JC, West MP (eds.).
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Nicod LP (July 2006). "Mechanisms of airway obliteration after lung transplantation".
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forming the immune system—must be of the individual who donated the organ or of an
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Lama VN, Murray S, Lonigro RJ, Toews GB, Chang A, Lau C, et al. (June 2007).
58:
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Mak TW, Saunders ME, Jett BD, eds. (2014-01-01). "Chapter 17 - Transplantation".
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entering with marrow recognize the new host tissues as foreign and destroy them.
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is being investigated to delay or prevent chronic rejection of lung transplants.
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West LJ (October 2011). "ABO-incompatible hearts for infant transplantation".
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2267:"Gene therapy progress and prospects: gene therapy in organ transplantation"
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2175:"The histology of kidney transplant failure: a long-term follow-up study"
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1980:
1963:
1281:"Human Leukocyte Antigen (HLA) System - Immunology; Allergic Disorders"
680:
418: in this section. Unsourced material may be challenged and removed.
350:
129:
2090:
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Hitchens TK, Ye Q, Eytan DF, Janjic JM, Ahrens ET, Ho C (April 2011).
1883:(Sixth ed.). Edinburgh: Churchill Livingstone. pp. 853–933.
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2419:
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178:
54:
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2222:
Yang JY, Sarwal MM (May 2017). "Transplant genetics and genomics".
1915:
Dobbels F, Hames A, Aujoulat I, Heaton N, Samyn M (February 2012).
2854:
2522:
757:"The effect of HLA-C matching on acute renal transplant rejection"
249:
949:(Third ed.). Philadelphia: W.B. Saunders. pp. 591–608.
16:
Rejection of transplanted tissue by the recipient's immune system
3444:
1656:(Fourth ed.). Philadelphia: Elsevier. pp. 661–675.e7.
1034:(Fourth ed.). Philadelphia: Elsevier. pp. 661–675.e7.
568:
539:
476:
475:. Where calcineurin inhibitors or steroids are contraindicated,
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2475:
1534:
Clayton PA, McDonald SP, Russ GR, Chadban SJ (September 2019).
1431:
Boardman DA, Jacob J, Smyth LA, Lombardi G, Lechler RI (2016).
1078:(Fourth ed.). St. Louis: W.B. Saunders. pp. 335–356.
387:
288:(BOS), confirmed by a persistent drop—three or more weeks—in
265:
is considered a form of chronic antibody-mediated rejection.
1623:(Fourth ed.). Philadelphia: Mosby. pp. 1222–1231.
1001:(Second ed.). Boston: Academic Cell. pp. 457–486.
261:
with changes characteristic of a transplant glomerulopathy.
1801:
American Journal of Respiratory and Critical Care Medicine
755:
Frohn C, Fricke L, Puchta JC, Kirchner H (February 2001).
848:
Moreau A, Varey E, Anegon I, Cuturi MC (November 2013).
799:
Moreau A, Varey E, Anegon I, Cuturi MC (November 2013).
345:. The laboratory pathologist generally seeks three main
2306:
Giannoukakis N, Thomson A, Robbins P (September 1999).
1588:
Kidney Transplantation, Bioengineering and Regeneration
1359:
Kidney Transplantation, Bioengineering and Regeneration
1654:
Chronic Kidney Disease, Dialysis, and Transplantation
1032:
Chronic Kidney Disease, Dialysis, and Transplantation
947:
Chronic Kidney Disease, Dialysis, and Transplantation
906:
Pediatric Transplant and Oncology Infectious Diseases
304:
injury, then inflammatory lesions and recruitment of
2397:
2124:"Gene expression profiling in organ transplantation"
1487:"Mechanism of cellular rejection in transplantation"
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1395:Justiz Vaillant AA, Misra S, Fitzgerald BM (2022).
1109:"ABO-incompatible heart transplantation in infants"
77:
65:
31:
296:) by at least 20%. First noted is infiltration by
2973:Transfusion-associated graft-versus-host disease
1910:
1908:
1778:"Organ Procurement and Transplantation Network"
1403:. Treasure Island (FL): StatPearls Publishing.
1251:. Treasure Island (FL): StatPearls Publishing.
3748:List of organ transplant donors and recipients
2062:. The Johns Hopkins University. 8 August 2021.
1782:U.S. Department of Health & Human Services
1315:(Third ed.). Elsevier. pp. 191–197.
3098:
2487:
1540:Journal of the American Society of Nephrology
671:replenishing exhausted blood cells including
8:
3347:Post-transplant lymphoproliferative disorder
1846:Proceedings of the American Thoracic Society
1742:The European Respiratory Journal. Supplement
577:post-transplant lymphoproliferative disorder
1076:Acute Care Handbook for Physical Therapists
908:. Philadelphia: Elsevier. pp. 1–9.e3.
854:Cold Spring Harbor Perspectives in Medicine
805:Cold Spring Harbor Perspectives in Medicine
593:Monoclonal anti-IL-2Rα receptor antibodies
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3091:
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608:Monoclonal anti-IL-6R receptor antibodies
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873:
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434:Learn how and when to remove this message
1738:"Current status of lung transplantation"
1193:"ABO-incompatible organ transplantation"
1150:Current Opinion in Organ Transplantation
3007:Allergic bronchopulmonary aspergillosis
1197:International Journal of Immunogenetics
747:
1736:Lau CL, Patterson GA (November 2003).
1581:
1579:
1243:Justiz Vaillant AA, Mohseni M (2022).
1238:
1236:
353:, perhaps accompanied by infiltrating
96:tissue is rejected by the recipient's
2829:Post-streptococcal glomerulonephritis
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761:Nephrology, Dialysis, Transplantation
7:
2353:The Journal of Experimental Medicine
1590:. Academic Press. pp. 223–234.
1361:. Academic Press. pp. 461–474.
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416:adding citations to reliable sources
146:is most commonly from antibodies to
3491:Canadian Society of Transplantation
3486:American Society of Transplantation
2265:Bagley J, Iacomini J (April 2003).
2128:International Journal of Nephrology
1309:Transfusion Medicine and Hemostasis
1245:"Chronic Transplantation Rejection"
1113:The New England Journal of Medicine
1889:10.1016/B978-0-7020-3398-8.00015-5
1662:10.1016/B978-0-323-52978-5.00043-4
1629:10.1016/b978-0-323-05876-6.00105-2
1596:10.1016/b978-0-12-801734-0.00017-5
1367:10.1016/B978-0-12-801734-0.00032-1
1321:10.1016/B978-0-12-813726-0.00032-5
1285:Merck Manuals Professional Edition
1084:10.1016/B978-1-4557-2896-1.00014-7
1040:10.1016/B978-0-323-52978-5.00043-4
1007:10.1016/B978-0-12-385245-8.00017-0
955:10.1016/B978-1-4377-0987-2.00041-8
914:10.1016/B978-0-323-64198-2.00010-5
850:"Effector mechanisms of rejection"
801:"Effector mechanisms of rejection"
618:Polyclonal anti-T-cell antibodies
14:
3046:Autoimmune polyendocrine syndrome
2308:"Gene therapy in transplantation"
1881:MacSween's Pathology of the Liver
1621:Comprehensive Clinical Nephrology
1433:"What Is Direct Allorecognition?"
1397:"Acute Transplantation Rejection"
3417:United Network for Organ Sharing
3402:National Transplant Organization
2683:Hemolytic disease of the newborn
1933:10.1111/j.1399-3046.2011.01633.x
1707:10.1111/j.1399-3046.2004.00270.x
1210:10.1111/j.1744-313x.2012.01101.x
687:(GVHD), however, whereby mature
635:Monoclonal anti-CD20 antibodies
392:
175:major histocompatibility complex
141:ABO-incompatible transplantation
128:in the recipient that recognize
3531:Organ transplantation in Israel
2865:Subacute bacterial endocarditis
2727:Immune thrombocytopenic purpura
2026:. The Johns Hopkins University.
1437:Current Transplantation Reports
403:needs additional citations for
378:Gene Expression Profiling (GEP)
3536:Organ transplantation in Japan
3507:Organ transplantation in China
3481:American Society of Nephrology
2079:Magnetic Resonance in Medicine
463:can be applied, and repeated.
316:Rejection due to non-adherence
1:
3412:Trillium Gift of Life Network
3392:National Marrow Donor Program
2945:Postorgasmic illness syndrome
999:Primer to the Immune Response
583:for named-patient use only.)
3450:Halachic Organ Donor Society
3377:Gift of Life Marrow Registry
3002:Hypersensitivity pneumonitis
1755:10.1183/09031936.03.00022103
1162:10.1097/MOT.0b013e32834a97a5
579:. (OKT3 is available in the
459:A short course of high-dose
380:—offer noninvasive testing.
3455:Kidney Foundation of Canada
3068:Systemic autoimmune disease
2904:Allergic contact dermatitis
2824:Hypersensitivity vasculitis
2707:Autoimmune hemolytic anemia
2192:10.1097/TP.0000000000000183
1126:10.1056/NEJM200103153441102
866:10.1101/cshperspect.a015461
817:10.1101/cshperspect.a015461
3845:
3512:harvesting from Falun Gong
3460:National Kidney Foundation
3316:Non-heart-beating donation
2574:common allergies include:
1813:10.1164/rccm.200609-1344OC
1485:Ingulli E (January 2010).
367:magnetic resonance imaging
158:
138:
18:
3743:
3342:Graft-versus-host disease
1968:Pediatric Transplantation
1921:Pediatric Transplantation
1858:10.1513/pats.200601-007AW
1695:Pediatric Transplantation
1503:10.1007/s00467-008-1020-x
1449:10.1007/s40472-016-0115-8
726:Graft-versus-tumor effect
721:Graft-versus-host disease
685:graft-versus-host disease
573:cytokine release syndrome
559:Antibody-based treatments
455:Immunosuppressive therapy
326:Pediatric Transplantation
263:Transplant glomerulopathy
45:
36:
21:Graft-versus-host disease
3829:Transplantation medicine
3407:NHS Blood and Transplant
2819:Henoch–Schönlein purpura
2634:Eosinophilic esophagitis
2224:Nature Reviews. Genetics
665:hematopoietic stem cells
628:Anti-lymphocyte globulin
473:anti-proliferative agent
349:signs: (1) infiltrating
290:forced expiratory volume
283:bronchiolitis obliterans
191:antigen-presenting cells
3824:Immune system disorders
3783:Immunosuppressive drugs
3519:Organ donation in India
2935:Hashimoto's thyroiditis
2722:Guillain–Barré syndrome
622:Anti-thymocyte globulin
483:Immunosuppressive drugs
189:, which are the body's
102:immunosuppressant drugs
82:Immunosuppressive drugs
3803:Frankenstein's monster
3798:Total body irradiation
3524:Gurgaon kidney scandal
3382:Human Tissue Authority
3036:Autoimmune adrenalitis
2060:Johns Hopkins Medicine
2036:Clinical trial number
2024:Johns Hopkins Medicine
1552:10.1681/ASN.2018111101
736:Transplant engineering
661:Bone marrow transplant
369:(MRI) of immune cells
270:
225:that begin to secrete
3788:Lung allocation score
3725:Jean-Michel Dubernard
3114:Organ transplantation
2325:10.1038/sj.gt.3300981
2284:10.1038/sj.gt.3302020
2020:"Kidney biopsy:risks"
683:. There is a risk of
567:anti-T cell antibody
469:calcineurin inhibitor
253:
193:(APCs), migrate from
3595:J. Hartwell Harrison
3352:Transplant rejection
3041:Autoimmune hepatitis
3020:Transplant rejection
2930:Giant cell arteritis
2860:Rheumatoid arthritis
2717:Goodpasture syndrome
2629:Autoimmune urticaria
2365:10.1084/jem.20081937
1491:Pediatric Nephrology
774:10.1093/ndt/16.2.355
524:Anti-proliferatives
412:improve this article
122:Hyperacute rejection
117:Hyperacute rejection
90:Transplant rejection
32:Transplant rejection
3704:André van der Merwe
3688:Richard C. Lillehei
3361:Transplant networks
3145:Xenotransplantation
3140:Autotransplantation
3128:Allotransplantation
2507:autoimmune diseases
2236:10.1038/nrg.2017.12
2141:10.4061/2011/180201
2056:"Lung biopsy:risks"
384:Rejection treatment
376:might—similarly to
333:Rejection detection
3559:Christiaan Barnard
3155:Organs and tissues
2950:Reactive arthritis
2940:Multiple sclerosis
2834:Reactive arthritis
2732:Pemphigus vulgaris
2712:Bullous pemphigoid
2613:Penicillin allergy
2549:Allergic urticaria
2446:External resources
2122:Gheith OA (2011).
2044:ClinicalTrials.gov
1981:10.1111/petr.14288
703:rejection via the
667:—the reservoir of
271:
203:lymphoid follicles
161:Histocompatibility
104:after transplant.
3811:
3810:
3793:Machine perfusion
3773:Edmonton protocol
3768:Biomedical tissue
3756:
3755:
3667:Vladimir Demikhov
3569:Adrian Kantrowitz
3321:Organ procurement
3080:
3079:
3076:
3075:
2981:
2980:
2873:
2872:
2782:
2781:
2778:
2777:
2770:Pernicious anemia
2765:Myasthenia gravis
2642:
2641:
2565:Atopic dermatitis
2554:Allergic rhinitis
2469:
2468:
2359:(13): 3133–3144.
2091:10.1002/mrm.22702
1898:978-0-7020-3398-8
1807:(11): 1192–1198.
1671:978-0-323-52978-5
1638:978-0-323-05876-6
1605:978-0-12-801734-0
1376:978-0-12-801734-0
1330:978-0-12-813726-0
1093:978-1-4557-2896-1
1049:978-0-323-52978-5
1016:978-0-12-385245-8
964:978-1-4377-0987-2
923:978-0-323-64198-2
731:Immunosuppression
673:white blood cells
656:Marrow transplant
533:Mycophenolic acid
444:
443:
436:
274:Chronic rejection
246:Chronic rejection
223:cytotoxic T-cells
134:complement system
87:
86:
26:Medical condition
3836:
3615:Michael Woodruff
3549:
3280:Medical grafting
3107:
3100:
3093:
3084:
3063:Sjögren syndrome
2992:
2894:
2799:
2695:
2674:
2534:
2503:Hypersensitivity
2496:
2489:
2482:
2473:
2399:
2387:
2386:
2376:
2344:
2338:
2337:
2327:
2318:(9): 1499–1511.
2303:
2297:
2296:
2286:
2262:
2256:
2255:
2219:
2213:
2212:
2194:
2170:
2164:
2163:
2153:
2143:
2119:
2113:
2112:
2102:
2085:(4): 1144–1153.
2070:
2064:
2063:
2052:
2046:
2034:
2028:
2027:
2016:
2010:
2009:
1983:
1959:
1953:
1952:
1912:
1903:
1902:
1876:
1870:
1869:
1841:
1835:
1834:
1824:
1792:
1786:
1785:
1774:
1768:
1767:
1757:
1733:
1727:
1726:
1690:
1684:
1683:
1649:
1643:
1642:
1616:
1610:
1609:
1583:
1574:
1573:
1563:
1546:(9): 1697–1707.
1531:
1525:
1524:
1514:
1482:
1471:
1470:
1460:
1428:
1419:
1418:
1416:
1415:
1392:
1381:
1380:
1354:
1343:
1342:
1314:
1303:
1297:
1296:
1294:
1292:
1287:. Merck & Co
1276:
1267:
1266:
1264:
1263:
1240:
1231:
1230:
1212:
1188:
1182:
1181:
1145:
1139:
1138:
1128:
1104:
1098:
1097:
1071:
1062:
1061:
1027:
1021:
1020:
994:
969:
968:
942:
936:
935:
901:
888:
887:
877:
845:
839:
838:
828:
796:
787:
786:
776:
752:
439:
432:
428:
425:
419:
396:
388:
53:rejection. Lung
41:
29:
3844:
3843:
3839:
3838:
3837:
3835:
3834:
3833:
3814:
3813:
3812:
3807:
3752:
3739:
3708:
3692:
3676:
3645:
3619:
3600:John P. Merrill
3583:
3540:
3495:
3474:Joint societies
3469:
3440:Blood Cancer UK
3427:
3421:
3364:
3362:
3356:
3330:
3302:
3298:Vascular bypass
3274:
3149:
3116:
3111:
3081:
3072:
3024:
2987:
2977:
2959:
2955:Type 1 diabetes
2925:Coeliac disease
2913:
2885:
2869:
2843:
2809:Arthus reaction
2790:
2774:
2760:Graves' disease
2741:
2737:Rheumatic fever
2686:
2654:
2638:
2617:
2544:Allergic asthma
2525:
2509:
2500:
2470:
2465:
2464:
2441:
2440:
2410:
2396:
2391:
2390:
2346:
2345:
2341:
2305:
2304:
2300:
2264:
2263:
2259:
2221:
2220:
2216:
2179:Transplantation
2172:
2171:
2167:
2121:
2120:
2116:
2072:
2071:
2067:
2054:
2053:
2049:
2035:
2031:
2018:
2017:
2013:
1961:
1960:
1956:
1914:
1913:
1906:
1899:
1878:
1877:
1873:
1843:
1842:
1838:
1794:
1793:
1789:
1776:
1775:
1771:
1735:
1734:
1730:
1692:
1691:
1687:
1672:
1651:
1650:
1646:
1639:
1618:
1617:
1613:
1606:
1585:
1584:
1577:
1533:
1532:
1528:
1484:
1483:
1474:
1430:
1429:
1422:
1413:
1411:
1394:
1393:
1384:
1377:
1356:
1355:
1346:
1331:
1312:
1305:
1304:
1300:
1290:
1288:
1278:
1277:
1270:
1261:
1259:
1242:
1241:
1234:
1190:
1189:
1185:
1147:
1146:
1142:
1119:(11): 793–800.
1106:
1105:
1101:
1094:
1073:
1072:
1065:
1050:
1029:
1028:
1024:
1017:
996:
995:
972:
965:
944:
943:
939:
924:
903:
902:
891:
860:(11): a015461.
847:
846:
842:
811:(11): a015461.
798:
797:
790:
754:
753:
749:
744:
717:
697:
658:
649:
561:
490:Corticosteroids
477:mTOR inhibitors
461:corticosteroids
457:
440:
429:
423:
420:
409:
397:
386:
341:or even tissue
335:
318:
302:epithelial cell
295:
248:
199:lymphoid tissue
187:dendritic cells
166:Acute rejection
163:
157:
155:Acute rejection
148:ABO blood group
143:
119:
110:
51:lung transplant
27:
24:
17:
12:
11:
5:
3842:
3840:
3832:
3831:
3826:
3816:
3815:
3809:
3808:
3806:
3805:
3800:
3795:
3790:
3785:
3780:
3775:
3770:
3764:
3762:
3761:Related topics
3758:
3757:
3754:
3753:
3751:
3750:
3744:
3741:
3740:
3738:
3737:
3732:
3727:
3722:
3716:
3714:
3710:
3709:
3707:
3706:
3700:
3698:
3694:
3693:
3691:
3690:
3684:
3682:
3678:
3677:
3675:
3674:
3672:James D. Hardy
3669:
3664:
3662:Joel D. Cooper
3659:
3653:
3651:
3647:
3646:
3644:
3643:
3638:
3636:James D. Hardy
3633:
3627:
3625:
3621:
3620:
3618:
3617:
3612:
3610:Elizabeth Ward
3607:
3602:
3597:
3591:
3589:
3585:
3584:
3582:
3581:
3579:Norman Shumway
3576:
3571:
3566:
3564:James D. Hardy
3561:
3555:
3553:
3546:
3542:
3541:
3539:
3538:
3533:
3528:
3527:
3526:
3516:
3515:
3514:
3503:
3501:
3497:
3496:
3494:
3493:
3488:
3483:
3477:
3475:
3471:
3470:
3468:
3467:
3462:
3457:
3452:
3447:
3442:
3437:
3431:
3429:
3423:
3422:
3420:
3419:
3414:
3409:
3404:
3399:
3394:
3389:
3384:
3379:
3374:
3372:Eurotransplant
3368:
3366:
3363:and government
3358:
3357:
3355:
3354:
3349:
3344:
3338:
3336:
3332:
3331:
3329:
3328:
3323:
3318:
3312:
3310:
3308:Organ donation
3304:
3303:
3301:
3300:
3295:
3290:
3284:
3282:
3276:
3275:
3273:
3272:
3267:
3262:
3257:
3252:
3247:
3242:
3241:
3240:
3230:
3225:
3220:
3215:
3210:
3205:
3200:
3195:
3190:
3185:
3180:
3175:
3170:
3165:
3159:
3157:
3151:
3150:
3148:
3147:
3142:
3137:
3136:
3135:
3124:
3122:
3118:
3117:
3112:
3110:
3109:
3102:
3095:
3087:
3078:
3077:
3074:
3073:
3071:
3070:
3065:
3060:
3059:
3058:
3053:
3043:
3038:
3032:
3030:
3026:
3025:
3023:
3022:
3017:
3011:
3010:
3009:
2998:
2996:
2989:
2983:
2982:
2979:
2978:
2976:
2975:
2969:
2967:
2961:
2960:
2958:
2957:
2952:
2947:
2942:
2937:
2932:
2927:
2921:
2919:
2915:
2914:
2912:
2911:
2906:
2900:
2898:
2891:
2875:
2874:
2871:
2870:
2868:
2867:
2862:
2857:
2851:
2849:
2845:
2844:
2842:
2841:
2839:Serum sickness
2836:
2831:
2826:
2821:
2816:
2811:
2805:
2803:
2796:
2793:Immune complex
2784:
2783:
2780:
2779:
2776:
2775:
2773:
2772:
2767:
2762:
2756:
2754:
2743:
2742:
2740:
2739:
2734:
2729:
2724:
2719:
2714:
2709:
2703:
2701:
2692:
2688:
2687:
2685:
2680:
2678:
2671:
2670:
2669:
2668:
2667:
2662:
2644:
2643:
2640:
2639:
2637:
2636:
2631:
2625:
2623:
2619:
2618:
2616:
2615:
2610:
2609:
2608:
2603:
2598:
2593:
2588:
2583:
2578:
2567:
2562:
2557:
2551:
2546:
2540:
2538:
2531:
2511:
2510:
2501:
2499:
2498:
2491:
2484:
2476:
2467:
2466:
2463:
2462:
2450:
2449:
2447:
2443:
2442:
2439:
2438:
2427:
2411:
2406:
2405:
2403:
2402:Classification
2395:
2394:External links
2392:
2389:
2388:
2339:
2298:
2277:(8): 605–611.
2257:
2230:(5): 309–326.
2214:
2185:(4): 427–435.
2165:
2114:
2065:
2047:
2029:
2011:
1954:
1904:
1897:
1871:
1852:(5): 444–449.
1836:
1787:
1769:
1728:
1685:
1670:
1644:
1637:
1611:
1604:
1575:
1526:
1472:
1443:(4): 275–283.
1420:
1382:
1375:
1344:
1329:
1298:
1268:
1232:
1203:(4): 282–290.
1183:
1156:(5): 548–554.
1140:
1099:
1092:
1063:
1048:
1022:
1015:
970:
963:
937:
922:
889:
840:
788:
767:(2): 355–360.
746:
745:
743:
740:
739:
738:
733:
728:
723:
716:
713:
696:
693:
677:identical twin
657:
654:
648:
647:Blood transfer
645:
644:
643:
642:
641:
633:
632:
631:
625:
616:
615:
614:
606:
605:
604:
599:
587:Antibody drugs
581:United Kingdom
560:
557:
556:
555:
554:
553:
548:
537:
536:
535:
530:
522:
521:
520:
515:
504:
503:
502:
500:Hydrocortisone
497:
465:Triple therapy
456:
453:
442:
441:
400:
398:
391:
385:
382:
334:
331:
317:
314:
310:myofibroblasts
300:, followed by
293:
247:
244:
232:helper T-cells
159:Main article:
156:
153:
139:Main article:
118:
115:
109:
106:
85:
84:
79:
75:
74:
69:
63:
62:
43:
42:
34:
33:
25:
15:
13:
10:
9:
6:
4:
3:
2:
3841:
3830:
3827:
3825:
3822:
3821:
3819:
3804:
3801:
3799:
3796:
3794:
3791:
3789:
3786:
3784:
3781:
3779:
3776:
3774:
3771:
3769:
3766:
3765:
3763:
3759:
3749:
3746:
3745:
3742:
3736:
3733:
3731:
3730:Donna Mansell
3728:
3726:
3723:
3721:
3720:Alexis Carrel
3718:
3717:
3715:
3711:
3705:
3702:
3701:
3699:
3695:
3689:
3686:
3685:
3683:
3679:
3673:
3670:
3668:
3665:
3663:
3660:
3658:
3655:
3654:
3652:
3648:
3642:
3641:Thomas Starzl
3639:
3637:
3634:
3632:
3629:
3628:
3626:
3622:
3616:
3613:
3611:
3608:
3606:
3605:Joseph Murray
3603:
3601:
3598:
3596:
3593:
3592:
3590:
3586:
3580:
3577:
3575:
3574:Richard Lower
3572:
3570:
3567:
3565:
3562:
3560:
3557:
3556:
3554:
3550:
3547:
3543:
3537:
3534:
3532:
3529:
3525:
3522:
3521:
3520:
3517:
3513:
3510:
3509:
3508:
3505:
3504:
3502:
3498:
3492:
3489:
3487:
3484:
3482:
3479:
3478:
3476:
3472:
3466:
3463:
3461:
3458:
3456:
3453:
3451:
3448:
3446:
3443:
3441:
3438:
3436:
3435:Anthony Nolan
3433:
3432:
3430:
3428:organizations
3424:
3418:
3415:
3413:
3410:
3408:
3405:
3403:
3400:
3398:
3395:
3393:
3390:
3388:
3385:
3383:
3380:
3378:
3375:
3373:
3370:
3369:
3367:
3359:
3353:
3350:
3348:
3345:
3343:
3340:
3339:
3337:
3335:Complications
3333:
3327:
3324:
3322:
3319:
3317:
3314:
3313:
3311:
3309:
3305:
3299:
3296:
3294:
3293:Skin grafting
3291:
3289:
3288:Bone grafting
3286:
3285:
3283:
3281:
3277:
3271:
3268:
3266:
3263:
3261:
3258:
3256:
3253:
3251:
3248:
3246:
3243:
3239:
3236:
3235:
3234:
3231:
3229:
3226:
3224:
3221:
3219:
3216:
3214:
3211:
3209:
3206:
3204:
3201:
3199:
3196:
3194:
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3176:
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3146:
3143:
3141:
3138:
3134:
3131:
3130:
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3126:
3125:
3123:
3119:
3115:
3108:
3103:
3101:
3096:
3094:
3089:
3088:
3085:
3069:
3066:
3064:
3061:
3057:
3054:
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3048:
3047:
3044:
3042:
3039:
3037:
3034:
3033:
3031:
3027:
3021:
3018:
3015:
3014:Latex allergy
3012:
3008:
3005:
3004:
3003:
3000:
2999:
2997:
2993:
2990:
2984:
2974:
2971:
2970:
2968:
2966:
2962:
2956:
2953:
2951:
2948:
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2933:
2931:
2928:
2926:
2923:
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2920:
2916:
2910:
2907:
2905:
2902:
2901:
2899:
2895:
2892:
2889:
2884:
2883:cell-mediated
2880:
2876:
2866:
2863:
2861:
2858:
2856:
2853:
2852:
2850:
2846:
2840:
2837:
2835:
2832:
2830:
2827:
2825:
2822:
2820:
2817:
2815:
2814:Farmer's lung
2812:
2810:
2807:
2806:
2804:
2800:
2797:
2794:
2789:
2785:
2771:
2768:
2766:
2763:
2761:
2758:
2757:
2755:
2753:
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2169:
2166:
2161:
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2106:
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2092:
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2061:
2057:
2051:
2048:
2045:
2041:
2040:
2033:
2030:
2025:
2021:
2015:
2012:
2007:
2003:
1999:
1995:
1991:
1987:
1982:
1977:
1974:(5): e14288.
1973:
1969:
1965:
1958:
1955:
1950:
1946:
1942:
1938:
1934:
1930:
1926:
1922:
1918:
1911:
1909:
1905:
1900:
1894:
1890:
1886:
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1875:
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1103:
1100:
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729:
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718:
714:
712:
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706:
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694:
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686:
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478:
474:
470:
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454:
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450:
438:
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427:
417:
413:
407:
406:
401:This section
399:
395:
390:
389:
383:
381:
379:
375:
372:
368:
364:
360:
356:
352:
348:
344:
340:
332:
330:
327:
322:
315:
313:
311:
307:
303:
299:
291:
287:
284:
278:
275:
268:
264:
260:
256:
252:
245:
243:
239:
237:
233:
228:
224:
219:
216:
212:
208:
204:
200:
196:
192:
188:
182:
180:
176:
172:
167:
162:
154:
152:
149:
142:
137:
135:
131:
127:
123:
116:
114:
107:
105:
103:
99:
98:immune system
95:
91:
83:
80:
76:
73:
70:
68:
64:
60:
59:H&E stain
56:
52:
48:
44:
40:
35:
30:
22:
3657:Fikri Alican
3631:Fikri Alican
3351:
3019:
2909:Mantoux test
2570:Food allergy
2453:
2429:
2414:
2356:
2352:
2342:
2315:
2312:Gene Therapy
2311:
2301:
2274:
2271:Gene Therapy
2270:
2260:
2227:
2223:
2217:
2182:
2178:
2168:
2131:
2127:
2117:
2082:
2078:
2068:
2059:
2050:
2037:
2032:
2023:
2014:
1971:
1967:
1957:
1924:
1920:
1880:
1874:
1849:
1845:
1839:
1804:
1800:
1790:
1781:
1772:
1745:
1741:
1731:
1701:(1): 84–93.
1698:
1694:
1688:
1653:
1647:
1620:
1614:
1587:
1543:
1539:
1529:
1497:(1): 61–74.
1494:
1490:
1440:
1436:
1412:. Retrieved
1400:
1358:
1308:
1301:
1291:30 September
1289:. Retrieved
1284:
1260:. Retrieved
1248:
1200:
1196:
1186:
1153:
1149:
1143:
1116:
1112:
1102:
1075:
1031:
1025:
998:
946:
940:
905:
857:
853:
843:
808:
804:
764:
760:
750:
700:Gene therapy
698:
695:Gene therapy
659:
650:
586:
585:
562:
528:Azathioprine
495:Prednisolone
482:
481:
464:
458:
445:
430:
421:
410:Please help
405:verification
402:
373:
371:radiolabeled
359:plasma cells
347:histological
336:
325:
323:
319:
289:
279:
273:
272:
240:
220:
214:
210:
194:
183:
165:
164:
144:
121:
120:
111:
94:transplanted
92:occurs when
89:
88:
3735:Bruce Reitz
3387:LifeSharers
3365:departments
3326:Organ trade
3168:Bone marrow
2560:Anaphylaxis
2556:(Hay fever)
2455:MedlinePlus
2039:NCT00351559
1927:(1): 4–11.
1748:: 57s–64s.
1279:Delves PJ.
689:lymphocytes
612:Tocilizumab
597:Basiliximab
542:inhibitors
513:Ciclosporin
509:inhibitors
507:Calcineurin
449:ciclosporin
363:neutrophils
355:eosinophils
306:fibroblasts
298:lymphocytes
236:neutrophils
207:lymph nodes
171:lymphocytes
3818:Categories
3238:islet cell
3208:Heart–lung
3029:Autoimmune
2918:Autoimmune
2848:Autoimmune
2691:Autoimmune
2622:Autoimmune
2134:: 180201.
1414:2022-03-16
1401:StatPearls
1262:2022-03-16
1249:StatPearls
742:References
669:stem cells
602:Daclizumab
565:monoclonal
551:Everolimus
518:Tacrolimus
479:are used.
259:glomerulus
257:showing a
255:Micrograph
197:tissue to
126:antibodies
72:Immunology
47:Micrograph
3500:Countries
3213:Intestine
2699:Cytotoxic
2006:248242427
1990:1397-3142
932:228907807
639:Rituximab
575:and late
546:Sirolimus
424:June 2020
267:PAS stain
227:cytokines
215:recipient
211:recipient
209:) in the
78:Treatment
67:Specialty
3778:Eye bank
3681:Pancreas
3465:ORGANIZE
3426:Advocacy
3233:Pancreas
2988:multiple
2986:Unknown/
2788:Type III
2752:receptor
2601:Tree nut
2383:19047438
2334:10490759
2293:12692588
2244:28286337
2209:20703626
2201:25243513
2160:21845224
2109:21305593
1998:35436376
1941:22248250
1866:16799090
1831:17347496
1764:14621118
1723:25841425
1715:15667618
1680:81475473
1570:31308074
1521:21476231
1467:27909647
1409:30571031
1339:91582896
1257:30571056
1227:41947505
1219:22339811
1178:26070409
1170:21836514
1135:11248154
1058:81475473
884:24186491
835:24186491
783:11158412
715:See also
707:and CD8
286:syndrome
130:antigens
49:showing
3178:Corneal
2995:Foreign
2897:Foreign
2888:T cells
2879:Type IV
2802:Foreign
2677:Foreign
2648:Type II
2591:Seafood
2537:Foreign
2519:allergy
2436:D006084
2374:2605226
2252:2222755
2151:3154482
2100:3135171
1949:1895827
1822:1899272
1561:6727270
1512:2778785
1458:5107184
875:3808773
826:3808773
709:T cells
471:and an
467:adds a
374:in vivo
351:T cells
179:T-cells
3588:Kidney
3545:People
3397:NOD-Lb
3270:Vagina
3265:Uterus
3260:Thymus
3255:Spleen
3218:Kidney
3016:(I+IV)
2748:Type V
2586:Peanut
2515:Type I
2460:000815
2381:
2371:
2332:
2291:
2250:
2242:
2207:
2199:
2158:
2148:
2107:
2097:
2004:
1996:
1988:
1947:
1939:
1895:
1864:
1829:
1819:
1762:
1721:
1713:
1678:
1668:
1635:
1602:
1568:
1558:
1519:
1509:
1465:
1455:
1407:
1373:
1337:
1327:
1255:
1225:
1217:
1176:
1168:
1133:
1090:
1056:
1046:
1013:
961:
930:
920:
882:
872:
833:
823:
781:
361:, and
343:biopsy
55:biopsy
3713:Other
3697:Penis
3624:Liver
3552:Heart
3245:Penis
3223:Liver
3203:Heart
3173:Brain
3121:Types
2855:Lupus
2606:Wheat
2523:atopy
2248:S2CID
2205:S2CID
2002:S2CID
1945:S2CID
1719:S2CID
1676:S2CID
1335:S2CID
1313:(PDF)
1223:S2CID
1174:S2CID
1054:S2CID
928:S2CID
681:clone
679:or a
630:(ALG)
624:(ATG)
339:blood
195:donor
108:Types
3650:Lung
3445:DKMS
3250:Skin
3228:Lung
3198:Head
3193:Hand
3188:Face
3163:Bone
3133:ABOi
3056:APS2
3051:APS1
2965:GVHD
2652:ADCC
2581:Milk
2505:and
2431:MeSH
2379:PMID
2330:PMID
2289:PMID
2240:PMID
2197:PMID
2156:PMID
2132:2011
2105:PMID
1994:PMID
1986:ISSN
1937:PMID
1893:ISBN
1862:PMID
1827:PMID
1760:PMID
1711:PMID
1666:ISBN
1633:ISBN
1600:ISBN
1566:PMID
1517:PMID
1463:PMID
1405:PMID
1371:ISBN
1325:ISBN
1293:2020
1253:PMID
1215:PMID
1166:PMID
1131:PMID
1088:ISBN
1044:ISBN
1011:ISBN
959:ISBN
918:ISBN
880:PMID
831:PMID
779:PMID
569:OKT3
540:mTOR
308:and
292:(FEV
205:and
3183:Eye
2665:IgM
2660:IgG
2596:Soy
2576:Egg
2528:IgE
2425:T86
2416:ICD
2369:PMC
2361:doi
2357:205
2320:doi
2279:doi
2232:doi
2187:doi
2146:PMC
2136:doi
2095:PMC
2087:doi
1976:doi
1929:doi
1885:doi
1854:doi
1817:PMC
1809:doi
1805:175
1750:doi
1703:doi
1658:doi
1625:doi
1592:doi
1556:PMC
1548:doi
1507:PMC
1499:doi
1453:PMC
1445:doi
1363:doi
1317:doi
1205:doi
1158:doi
1121:doi
1117:344
1080:doi
1036:doi
1003:doi
951:doi
910:doi
870:PMC
862:doi
821:PMC
813:doi
769:doi
705:CD4
414:by
3820::
2750:"/
2458::
2434::
2423::
2420:10
2377:.
2367:.
2355:.
2351:.
2328:.
2314:.
2310:.
2287:.
2275:10
2273:.
2269:.
2246:.
2238:.
2228:18
2226:.
2203:.
2195:.
2183:98
2181:.
2177:.
2154:.
2144:.
2130:.
2126:.
2103:.
2093:.
2083:65
2081:.
2077:.
2058:.
2022:.
2000:.
1992:.
1984:.
1972:26
1970:.
1966:.
1943:.
1935:.
1925:16
1923:.
1919:.
1907:^
1891:.
1860:.
1848:.
1825:.
1815:.
1803:.
1799:.
1780:.
1758:.
1746:47
1744:.
1740:.
1717:.
1709:.
1697:.
1674:.
1664:.
1631:.
1598:.
1578:^
1564:.
1554:.
1544:30
1542:.
1538:.
1515:.
1505:.
1495:25
1493:.
1489:.
1475:^
1461:.
1451:.
1439:.
1435:.
1423:^
1399:.
1385:^
1369:.
1347:^
1333:.
1323:.
1283:.
1271:^
1247:.
1235:^
1221:.
1213:.
1201:39
1199:.
1195:.
1172:.
1164:.
1154:16
1152:.
1129:.
1115:.
1111:.
1086:.
1066:^
1052:.
1042:.
1009:.
973:^
957:.
926:.
916:.
892:^
878:.
868:.
856:.
852:.
829:.
819:.
807:.
803:.
791:^
777:.
765:16
763:.
759:.
711:.
589::
485::
357:,
57:.
3106:e
3099:t
3092:v
2890:)
2886:(
2881:/
2795:)
2791:(
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2650:/
2530:)
2526:(
2521:/
2517:/
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2418:-
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2385:.
2363::
2336:.
2322::
2316:6
2295:.
2281::
2254:.
2234::
2211:.
2189::
2162:.
2138::
2111:.
2089::
2008:.
1978::
1951:.
1931::
1901:.
1887::
1868:.
1856::
1850:3
1833:.
1811::
1784:.
1766:.
1752::
1725:.
1705::
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1682:.
1660::
1641:.
1627::
1608:.
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1572:.
1550::
1523:.
1501::
1469:.
1447::
1441:3
1417:.
1379:.
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1341:.
1319::
1295:.
1265:.
1229:.
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