Allogeneic transplant - Histology

What is an Allogeneic Transplant?

An allogeneic transplant involves transferring cells, tissues, or organs from a donor to a genetically non-identical recipient of the same species. This is commonly seen in bone marrow transplants and solid organ transplants such as kidneys, liver, and heart.

Histological Examination in Allogeneic Transplants

Histological examination is crucial for assessing the health of transplanted tissues. It helps in identifying rejection episodes, infection, and other complications. Tissue biopsies are often taken to evaluate the cellular architecture and detect any pathological changes.

Types of Rejection

- Hyperacute Rejection: Occurs within minutes to hours due to pre-existing antibodies against donor antigens.
- Acute Rejection: Happens within weeks to months and is mediated by T cells attacking the graft.
- Chronic Rejection: Develops over months to years, involving both immune and non-immune mechanisms leading to graft fibrosis and loss of function.

Histological Features of Rejection

- Acute Cellular Rejection: Characterized by lymphocytic infiltration and damage to the endothelium and parenchyma.
- Antibody-Mediated Rejection: Marked by capillaritis, glomerulitis, and presence of donor-specific antibodies.
- Chronic Rejection: Shows interstitial fibrosis, tubular atrophy, and vascular changes such as intimal hyperplasia.

Role of Immunosuppressive Therapy

Immunosuppressive drugs are administered to prevent rejection. Histological assessment helps in adjusting therapy by monitoring the extent of immune response. Common drugs include calcineurin inhibitors, antimetabolites, and corticosteroids.

Biomarkers in Histology

Biomarkers like C4d (complement component) deposition can indicate antibody-mediated rejection. Additionally, molecular markers are being researched to predict rejection and guide personalized treatment.

Complications and Histological Findings

- Infections: Opportunistic infections like CMV and BK virus can be identified by specific histological changes.
- Graft vs Host Disease (GvHD): In bone marrow transplants, donor immune cells attack the recipient's tissues, showing epithelial damage and lymphocytic infiltration.

Future Directions

Advances in immunohistochemistry and molecular pathology are enhancing the ability to diagnose and manage allogeneic transplants more effectively. Research is focused on finding new biomarkers and therapeutic targets to improve graft survival and patient outcomes.

Relevant Publications

Isolated myeloid sarcoma of the tibia: A case report.

Issue Release: 2024

Cyclophosphamide and thiotepa increases risk of transplant-associated thrombotic microangiopathy.

Issue Release: 2024

Effects of Total Body Irradiation on Hematopoietic Cell Transplantation Outcomes in Pediatric Acute Myeloid Leukemia with Prior Central Nervous System Involvement.

Issue Release: 2024

Anti-T-lymphocyte globulin (ATLG) compared to post-transplant cyclophosphamide as GvHD prophylaxis in ALL patients undergoing allogeneic stem cell transplantation.

Issue Release: 2024

Second allogeneic haematopoietic stem cell transplant conditioned with treosulfan and fludarabine is associated with encouraging overall survival and transplant related mortality in late relapse of myeloid malignancies.

Issue Release: 2024

Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Including Matched Sibling and Alternate Donor Transplants - Adaptations and Outcomes From a Tertiary Care Government Institute in India.

Issue Release: 2024

Trends in allogeneic hematopoietic cell transplantation survival using population-based descriptive epidemiology method: analysis of national transplant registry data.

Issue Release: 2024

Second Allogeneic Hematopoietic Cell Transplantation for Relapsed Adult Acute Myeloid Leukemia: Outcomes and Prognostic Factors.

Issue Release: 2024

Post-transplant cyclophosphamide compared to sirolimus/tacrolimus in reduced intensity conditioning transplants for patients with lymphoid malignancies.

Issue Release: 2024

Myelofibrosis and allogeneic transplantation: critical points and challenges.

Issue Release: 2024

Haploidentical HSCT in the Treatment of Pediatric Hematological Disorders.

Issue Release: 2024

Impact of post-transplant cyclophosphamide and splenomegaly on primary graft failure and multi-lineage cytopenia after allogeneic hematopoietic cell transplantation.

Issue Release: 2024

Identification of Pathogenic Pathways for Recurrence of Focal Segmental Glomerulosclerosis after Kidney Transplantation.

Issue Release: 2024

Is HLA-E with its receptors an immune checkpoint or an antigenic determinant in allo-HCT?

Issue Release: 2024

The role of chemotherapy in hematopoietic stem cell transplantation for autoimmune disorders: From lymphoablative to myeloablative conditioning protocols.

Issue Release: 2024

Efficacy and safety of adoptive T-cell therapy in treating cytomegalovirus infections post-haematopoietic stem cell transplantation: A systematic review and meta-analysis.

Issue Release: 2024

Case report: Autoimmune encephalomyelitis following cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation.

Issue Release: 2024

Hematopoietic stem cell transplantation: an Italian monocentric experience on the health assessment and eligibility of adult-related donors.

Issue Release: 2024

Post-Transplant Maintenance Therapy in Acute Myeloid Leukemia.

Issue Release: 2024

Immunoprotection Strategies in β-Cell Replacement Therapy: A Closer Look at Porcine Islet Xenotransplantation.

Issue Release: 2024

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