What causes hyperacute rejection of a lung transplant?

Updated: Aug 19, 2019
  • Author: Bryan A Whitson, MD, PhD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Hyperacute rejection arises within minutes after the newly transplanted organ begins to be perfused. Hyperacute rejection is mediated through preexisting antibodies against ABO blood groups, HLAs, or other antigens that interact with vascular endothelium. These cause activation of complement and the other cytokines and also lead to cell-mediated injury. The grafted organ demonstrates intravascular thrombosis, necrosis of vessel walls, and preoperative infiltration with mononuclear and polymorphonuclear cells. ABO blood group matching and preoperative screening for antibodies against common antigens largely has eliminated this problem. This is usually a fatal complication.

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