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Significance of the major histocompatibility complex for organ transplantation
Ilina, Liudmila ; Slavčev, Antonij (advisor) ; Grobárová, Valéria (referee)
The major histocompatibility system is a region in the human genome located on chromosome 6. HLA genes encode polymorphic cell-surface glycoproteins which are primarily responsible for presentation of self and non-self antigens to T cells. When the T lymphocyte recognizes the MHC-peptide complex as foreign, it activates effector components of the innate and adaptive immune system. Therefore, mismatched HLA antigens can lead to a strong immune response against the donor's tissue. HLA laboratories support transplant programs by evaluation the HLA matching between patients and their potential donors and, based on these data, assist in the evaluation of the risk of rejection and eventual immunological complications after transplantation. The aim of this thesis is to describe the significance of the major histocompatibility complex for the occurrence of cellular and antibody-mediated rejection after solid organ transplantation and discuss the relationship between the degree of HLA matching and graft survival outcomes. Key words HLA, organ transplantation, rejection
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A Case Study of Physiotherapy Treatment on a Patient After LiverTransplantation
Al Saseh, Saria ; Kučerová, Ilona (advisor) ; Vomáčková, Helena (referee)
Název: Případová studie fyzioterapeutické léčby pacienta po transplantaci jater Autor: Saria Al Saseh Cíl: Cílem této práce je podrobně zkoumat teoretické aspekty související s postupy transplantace jater a s nimi spojeným rehabilitačním procesem. Druhá část zahrnuje podrobnou analýzu případu, která popisuje fyzioterapii, která byla podána pacientovi v raném pooperačním období po transplantaci jater. Klinické zjištění: Případová studie je založena na 43letém pacientovi po transplantaci jater kvůli cirhóze způsobené Wilsonovou chorobou. Vyšetření ukázalo snížení nezávislosti, svalové síly, rozsahu pohybu, změn ve vzorci dýchání a měkkých tkání. Metody: Metoda použitá v této případové studii je založena na terapeutických technikách naučených na FTVS Univerzity Karlovy. Výsledky: Pacient během rehabilitačního procesu prokázal významné zlepšení. Tento pokrok umožnil pacientovi dosáhnout nezávislosti a zlepšit kvalitu života. Závěr: Použité terapie byly užitečné a úspěšné při řešení specifické diagnózy pacienta. Klíčová slova: Játra, transplantace, fyzioterapie, Wilsonova choroba
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Role of antibodies against HLA and non HLA antigens for organ transplantation.
Svobodová, Eva
Rejection is a significant complication after transplantation and one of the main reasons for loss of graft function. It is triggered by the response of the organ recipient's immune system based on the recognition of mismatched HLA (Human Leukocyte Antigens) and non-HLA antigens of the donor. All components of the immune system participate in this process, and according to the predominance of individual reactions, rejection can be divided into T cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR). Rejection can develop immediately after transplantation in an acute form, or as a chronic form during several to tens of years after transplantation. The diagnosis of rejection is determined according to the clinical status, laboratory tests (including the detection of donor-specific antibodies, DSA) and histological findings in biopsies. The knowledge of validated gene expressions from the molecular microscope (MMDX) and other diagnostic tests has been recently applied. Individual phenotypes of rejection are evaluated and revised according to the international pathological classification. This work focuses on the analysis of immunological factors in relation to T-cell and antibody- mediated rejection after organ transplantation. The thesis deals with the determination of DSA in relation...
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Role of antibodies against HLA and non HLA antigens for organ transplantation.
Svobodová, Eva ; Slavčev, Antonij (advisor) ; Mrázek, František (referee) ; Černá, Marie (referee)
Rejection is a significant complication after transplantation and one of the main reasons for loss of graft function. It is triggered by the response of the organ recipient's immune system based on the recognition of mismatched HLA (Human Leukocyte Antigens) and non-HLA antigens of the donor. All components of the immune system participate in this process, and according to the predominance of individual reactions, rejection can be divided into T cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR). Rejection can develop immediately after transplantation in an acute form, or as a chronic form during several to tens of years after transplantation. The diagnosis of rejection is determined according to the clinical status, laboratory tests (including the detection of donor-specific antibodies, DSA) and histological findings in biopsies. The knowledge of validated gene expressions from the molecular microscope (MMDX) and other diagnostic tests has been recently applied. Individual phenotypes of rejection are evaluated and revised according to the international pathological classification. This work focuses on the analysis of immunological factors in relation to T-cell and antibody- mediated rejection after organ transplantation. The thesis deals with the determination of DSA in relation...
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Legal and ethical aspects of human organ and tissue transplantation
Kubíková, Natálie ; Salač, Josef (advisor) ; Šolc, Martin (referee)
1 Abstract Legal and ethical aspects of human organ and tissue transplantation The topic of this thesis is Legal and ethical aspects of human organ and tissue transplantation. It provides an overview of current legislation related to the issue of transplantation of human organs and tissues. Subsequently, it analyzes the most basic ethical dilemmas, which are faced by the professional and lay public in connection with the legal regulation of the transplantation process, then supplements them with the author's view of the matter, including recommendations de lege ferrenda. The thesis is divided into six chapters, including the introduction and conclusion; the chapters are further divided into individual subsections. The information used to write this thesis was obtained from academic literature in the form of monographs, commentaries, academic articles, jurisprudence and legal regulations, including their explanatory reports. Furthermore, the text is based on internet sources and the podcast of the Institute of Clinical and Experimental Medicine. The aim of this work is to analyze the legal situation, outline the basic ethical questions, including the arguments that are connected with them, and then bring them into confrontation with contemporary legislation through considerations de lege ferrenda....
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Mechanisms of immune response against kidney allograft
Švachová, Veronika
Kidney transplantation improves the prognosis and quality of life of patients with end- stage renal disease. However, the occurrence of rejection still represents a major complication that can lead to failure of allograft function. In our work, we have studied the phenotypic changes of subpopulations of B lymphocytes and monocytes, which represent one of the key players involved in immune responses against kidney transplantation. In the part of the research devoted to B lymphocytes, we have observed a different redistribution of individual B cell compartments in the peripheral blood during the first year after transplantation without significant differences between used immunosuppression. We have demonstrated that sensitized and rejected patients had a lower level of IgMhigh CD38high CD24high transient B cells. These results support the hypothesis of a protective role of transient B lymphocytes. Activation of monocyte subpopulations in peripheral blood in the posttransplantation perion was also subject of research. We have compared a cohort of patients with normal graft function with a group of patients with acute rejection. The level of "transient" monocytes and HLA-DR expression in a subset of "non-classical" monocytes did not decrease in patients with rejection, compared to the group with a...
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Mechanisms of immune response against kidney allograft
Švachová, Veronika ; Stříž, Ilja (advisor) ; Mrázek, František (referee) ; Posová, Helena (referee)
Kidney transplantation improves the prognosis and quality of life of patients with end- stage renal disease. However, the occurrence of rejection still represents a major complication that can lead to failure of allograft function. In our work, we have studied the phenotypic changes of subpopulations of B lymphocytes and monocytes, which represent one of the key players involved in immune responses against kidney transplantation. In the part of the research devoted to B lymphocytes, we have observed a different redistribution of individual B cell compartments in the peripheral blood during the first year after transplantation without significant differences between used immunosuppression. We have demonstrated that sensitized and rejected patients had a lower level of IgMhigh CD38high CD24high transient B cells. These results support the hypothesis of a protective role of transient B lymphocytes. Activation of monocyte subpopulations in peripheral blood in the posttransplantation perion was also subject of research. We have compared a cohort of patients with normal graft function with a group of patients with acute rejection. The level of "transient" monocytes and HLA-DR expression in a subset of "non-classical" monocytes did not decrease in patients with rejection, compared to the group with a...
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Case Study of Physiotherapy Treatment of an Adult Patient after a liver transplant
Mahenová, Barbora ; Stupková, Michaela (advisor) ; Nováková, Tereza (referee)
Author: Barbora Mahenová Supervisor: Mgr. Michaela Stupková Title: Case report of physiotherapeutic care of an adult patient after liver transplantation Objectives: The main aim of this bachelor thesis is to summarize the theoretical information about liver transplantation and to prepare a detailed case report of an adult patient who underwent this surgery. Methods: The theoretical part summarizes the knowledge about liver transplantation, specifically about indications and contraindications for transplantation, waiting list, organ donation, complications of the procedure, immunosuppressive therapy and quality of life of patients after liver transplantation. Furthermore, the theoretical part covers the general principles of rehabilitation after transplantation and physiotherapeutic examination and therapeutic methods and procedures. The special part includes a detailed case study of physiotherapeutic care of a patient who has undergone liver transplantation. The case report also includes a description of the therapies that took place as part of a continuous professional practice at the Institute of Clinical and Experimental Medicine in Prague between January and February 2023. Results: The patient achieved an improvement in fitness and a significant reduction in pain in the surgical wound area over...
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The ethical aspects of handeling the bodies of deceased
VIKTOROVÁ, Nikola
The diploma thesis deals with the ethical aspects we can indentify when dealing with bodies of the deceased. It describes how the deceased body is treated with respect to human dignity or human rights and also shows how the deceased's body was treated in the past and how funeral ceremonies and burials of the human remains looked like. It also deals with the evaluation of the approach to dead body these days. The procedures after death are described as well as the forms of funeral, funeral services or cemeteries. The thesis marginally deals with the funeral customs of selected ethnic minorities living in our territory. A special area is dedicated to the treatment of deceased children, the possibilities of their burial and farewell to their parents. Ethical issues in the field of organ donation are presented here also in the end.
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