Exploring Tissue Transplantation and Rejection: A Molecular Case Study

This essay examines tissue transplantation and rejection through a case study of Mr. X, a burn victim requiring a skin autograft. It discusses the immunological challenges of tissue transplantation, focusing on the role of HLA proteins and MHC complexes in graft rejection. The essay explores different types of tissue transplantation, including skin allografts and corneal transplants, highlighting the varying degrees of immune rejection. It also delves into the mechanisms of immunological rejection, involving both B cell-dependent and T cell-dependent responses. Furthermore, the essay discusses current treatments, such as immunosuppressive drugs, and ethical considerations in tissue procurement and transplantation. The importance of donor screening and tissue sterilization to prevent disease transmission is emphasized. Ultimately, the essay underscores the life-saving potential of tissue transplantation while acknowledging the significant immunological hurdles, particularly in skin transplantation, and the strategies to improve graft survival.

Running head: TISSUE TRANSPLANTATION AND REJECTION
TISSUE TRANSPLANTATION AND REJECTION
Name of the Student:
Name of the University:
Authors note:

1TISSUE TRANSPLANTATION AND REJECTION
Case study
Mr. X was brought to emergency department of ABC hospital. One side of his right
forearm was completely burnt. Mr. X is a 50 year old man who works as a restaurant chef.
While he was cooking suddenly his chef apron caught fire which lead to third degree burn in
the forearm. Mr. X was subconscious when admitted to hospital. Hospital dermatologist
suggested transplantation of his own tissue (Mr. X’s tissues) from his thigh to his fore-arm
(autograft).
From the above case study it could be understood that tissue transplantation or cellular
transplantation can help save lives and also regulate the bodily functions. There are different
types of transplantations, like the organ transplantation, tissue transplantation and cellular
transplantation. Tissue transplantation is a method when the tissues are taken from the donor
and then it is transplanted with the help of surgery to another person. This is a new field of
transplant immunology. Though has the potential to save lives, the immune system response
to the rejection of the graft or the tissues pose a crucial barrier in the field of Tissue
transplantation (Vallabhajosyula et al. 2017).
There different types of tissue transplantations that takes place world-wide including the
corneal transplantation which has been performed over 100 years and it has reduced
incidence of immune rejection and hence, enjoy an immune privilege. However, when it
comes to the skin allografts or skin transplantation there can be 100 % rejection of the host,
due major histocompatibility barriers (Niederkorn 2013).The immune system’s main
objective is to reject any kind of foreign particles when introduced in the body. The graft
depends upon various factors, for instance, the receiver has its own sets of HLA proteins that
has to exclusively match the donor to produce the histocompatibility. According to Hautz et
al. (2013), skin is the largest organ of the body and often the skin rejection is observed

2TISSUE TRANSPLANTATION AND REJECTION
frequently, especially in head and face transplantation. It is mostly due to auto rejection, in
post-operative case, and skin and vessels get affected in case of transplantation. The skin has
an effective immune system and has high antigenicity. It is due to skin’s high antigenicity and
antigen presenting cells. Moreover, the first layer of the dermis is epidermis which is majorly
composed of keratinocytes, which can produce MHC or Major histocompatibility complex,
and these are class II molecules.
As per the technology that is used to detect the acute rejection of the allograft is by the
histological analysis of graft biopsy, which is accordance with international classification
system. Inheritance can also influence the histocompatibility of antigens and tolerance
towards allografts (Moreau et al. 2013). The mechanism through which the immunological
mechanism forms is the combination of the B cell dependent which is in correlation with the
acute humoral rejection and the T cell dependent that give rise to acute cellular rejection.
From this, it can be observed that the transplantation tolerance could be improved over the
time. According to Cunnighamet al. (2013), the tolerance is related to the antigen specificity
and obtaining high level gene expression is important for induction of tolerance. Hence, the
gene therapy with respect to the allograft transplantation could alter the gene expression. The
induction of molecular chimerism through genetic modification can increase the tolerance for
allograft transplantation (Jindra et al. 2013). It is to be understood that skin graft rejection is
done in case of healing a wound and also in the case where the patient has burns and
therefore, tissue is transplanted.
The current treatment includes immunosuppressive drugs in order to make the patient‘s
immune response more tolerant. There are multiple immunosuppression therapies that could
induce long term graft survival (Ebrahimi, Hosseini, and Rahim, 2014). Which includes:
 Calcinuerin inhibitor

3TISSUE TRANSPLANTATION AND REJECTION
 Anti-proliferative agents
 Corticosteroids.
During the transplantation the ethics of procurement should be maintained and the consent of
the patient who is donating the organ / tissue / cell should be essentially taken, furthermore,
the consent of the receiver of the graft should be taken as well. The human tissues that are
used for allografts should be processed by tissue establishment, a rigorous safety standard
protocol has to be followed that has to be in incorporation with the code of practice. The
adverse events and side effects of the post-operative outcome has to be well explained. The
screening of the donor should be well evaluated and which has to be done to analyse the
histocompatibility of the donor. The appropriate blood testing should be conducted as well
the tissues used should be disinfected and will sterilized to avoid any kind of infection to the
receiver. There is a possibility of disease transmission that should be properly evaluated
before donating the graft.
From the above discussion, it could be understood that, there are different types of
tissue, organ and cell transplantation takes place throughout the world and due to this many
lives are saved worldwide. However, skin transplantation can have severe immunological
antagonism and the MHC complex are involved in it.

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References:
Cunningham, E.C., Tay, S.S., Wang, C., Rtshiladze, M., Wang, Z.Z., McGuffog, C.,
Cubitt, J., McCaughan, G.W., Alexander, I.E., Bertolino, P. and Sharland, A.F., 2013.
Gene therapy for tolerance: high-level expression of donor major histocompatibility
complex in the liver overcomes naive and memory alloresponses to skin
grafts. Transplantation, 95(1), pp.70-77.
Ebrahimi, A., Hosseini, S.A. and Rahim, F., 2014. Immunosuppressive therapy in
allograft transplantation: from novel insights and strategies to tolerance and
challenges. Central-European journal of immunology, 39(3), p.400.
Hautz, T., Zelger, B.G., Weißenbacher, A., Zelger, B., Brandacher, G., Landin, L.,
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Moreau, A., Varey, E., Anegon, I. and Cuturi, M.C., 2013. Effector mechanisms of
rejection. Cold Spring Harbor perspectives in medicine, 3(11), p.a015461.

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Niederkorn, J.Y., 2013. Corneal transplantation and immune privilege. International
reviews of immunology, 32(1), pp.57-67.
Vallabhajosyula, P., Korutla, L., Habertheuer, A., Yu, M., Rostami, S., Yuan, C.X.,
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