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Biotech Exam 3 (simplified notes)

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Brown University
BIOL 0170
Beth Zielinski

Shortened study sheet (study at your own risk) PPT1: organ transplantation • UNOS (United network of organ sharing) o 120078 on waiting list o 77067 active waiting list candidates o 16669 transplants jan­july o 8215 donors jan­july • Transplantation o Autologous  From yourself o Isogeneic  From identical twin or genetically identical o Allogeneic  From same species o Xenogeneic  From different species • Immune recognition o MHC/HLA (human leukocyte antigens)  Immune recognition  Hyper/acute/chronic rejection o ABO  Hyperacute rejection   Blood type • MHC/HLA  o Cell surface antigens o 200 genes on chromosome 6 o 3 classes  class 1: cell surface antigens  class 2: immune cells  class 3: complement system components o combination of HLA makes you unique • Testing for a match o ABO blood tests  Test rbcs o Mixed leukocyte culture  Test wbcs o Serological cross­matching  Serum Ab­antigen testing for both ABO and HLA o DNA typing  Allele mismatches • Rejection reactions o Patients need to match according to HLA tissue typing  Closer match  ▯more well tolerated  Only identical twins are complete match  Blood type must match too o Direct pathways  Acute rejection (right away) • T­cells recognize foreign HLA  o KILLLLLL o Indirect pathways  Chronic or late rejection o Graft vs host response  Donated cells view host as enemy, KILLLLLL o Hyperacute rejection  Within first 48 hrs  Antibody­mediated  Caused by pre­existing antibodies in recipient  Fever and anuria o Acute rejection  Within first 6­90 days  Lymphocytes activated against donor antigens  Anti­donor antibodies developed o Chronic rejection  Months to years  Antibody and cell­mediated  Fibrosis and scarring  Immunosuppressive therapy o Medication  Can cost up to 2500/month • Companies/groups o UNOS (united network for organ sharing) o Organ Procurement Organizations  Buying/selling organs irregal in states • Kidney transplants o 14000 transplants/year o 2000 organs/year o number has remained relatively constant • DONOR AND RECIPIENT DO NOT DEAL DIRECTLY WITH EACH OTHER o IS BAD. IRREGAL. BAD.  Go through transplant centers, organ procurement organizations PPT2: organ transplantation 2 • Face transplants o First successful one in 2005 o Isabelle dinoire • Xenotransplantation o Transplant organs from diff animal  Pig (oink) heart similar to human heart; can transplant • Diseases can be contracted from the piggy PPT3: Biotechnology in the cardiovascular system • <3 diseases o Leading cause is diabetes o Costs US 108.9 billion/year • 3 distinct parts of coronary blockage o atheroma  accumulation of soft yellowish material at center of large plaques   made of macrophages o cholesterol crystals o calcification at base of older lesions • initial lesion  ▯fatty streak  ▯intermediate lesion  ▯atheroma  ▯fibroatheroma  ▯ complicated lesion • atherosclerosis o soft plaque  more likely to break off   can cause blood clots the block blood flow o hard plaque  cause artery walls to harden  contains calcium o main worry is stroke • Effects of plaque (soft and hard if you know what I mean) o Coronary <3 disease  Arteries feeding <3 are clogged o Stroke  Arteries feeding brain clogged  o Peripheral  Arteries feeding arms, legs, pelvis clogged o Renovascular  Arteries feeding kidneys clogged • Angioplasty (PCI) o Fluoroscopic injection to see vasculature o Starts in femoral artery (in leg)  When clog is found, inflate balloon and crush plaque o 1.5 million procedures in US (rising) o 69% male, 50% over 65 (remaining constant) o 20,000 per patient o 70% with stents • Restenosis o Crushing plaque against wall affects endothelial lining, grows back and  artery gets thin and obstructs blood flow o Need stent  Taxol: keeps muscles from growing through stent • Causes blood clotting tho • CABG, OPCAB, MIDCAP o CABG  30cm incision  7­10 day hospital stay, 6­10 week recovery  5 arteries bypassed  35000­45000  <3 stopped  Uses ECMO  3­6 hour surgery  2.9% mortality o OPCAB  20­30 cm incision  6­10 day stay, 4­6 week recovery  4 arteries bypassed  25% less cost than CABG  <3 not stopped  No ECMO  2
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