Face transplant recipient’s donor face now failing

Post by sandworm101 » Mon, Sep 23, 2019, 5:35 PM UTC

arkades wrote: post #23

radlad wrote: post #20

Earlier quoted context omitted.

> Any time we do any transplant immunosupressants are given to the recipient for the rest of their life, but this only slows the inevitable. Is this true that it is inevitable? My understanding, from my girlfriend attending medical school (only M1), is that for many types of transplants, when immunosupressants are taken properly, it is unlikely that the organ will ever be rejected. For example, only 10-20% of patient…

“Only 20%” and “unlikely to ever be rejected” are worlds apart. Modern immunosuppressive therapy for, for instance kidneys, has dropped the five year acute rejection rate from 50% to 20%. About 8-10% in the first year. You can get a 5% 10-year non-rejection rate only in the most hand-picked groups (adheres to meds, no underlying systemic disease, and no chronic nephropathy). That sub-population exists, but it’s prett…

Post by airstrike » Mon, Sep 23, 2019, 5:44 PM UTC

abbirdboy wrote: post #22

peterlk wrote: post #12

Earlier quoted context omitted.

I just finished up an introductory biology lecture series, and this suddenly makes less sense to me than it did before. What is it about the foreign cells that is identified as foreign by the host cells? The cells ought to be remarkably similar. They're human, with the same function/pluripotency using the same protein interactions. So why attack it?

Adding to some of the other comments: Leukocytes (immune cells) such as B and T cells will undergo "education" when they are developing. For example, B cells, before being released, will go through something called central tolerance in the bone marrow. If the B cell receptors bind a "self" antigen (markers that are associated with our own cells) while developing, it will go through negative selection and be destroyed…

Post by aphextim » Mon, Sep 23, 2019, 5:45 PM UTC

xwdv wrote: post #25

aphextim wrote: post #21

Earlier quoted context omitted.

Probably has some sort of MAC address identifier that can detect whether something if different than the host DNA, but I have no idea nor experience in biology.

I’d say it’s probably more like some kind of checksum against the DNA. If the body detects something has been changed from what was there before it dispatches the white blood cells to kill it off. Immunosuppressants are a way to bypass the checksum, but only for some limited time. Maybe we need a way to change the checksum values altogether, but then the whole body could be rendered rejected and cease to function (de…

Post by robbiep » Mon, Sep 23, 2019, 5:48 PM UTC

Pete_D wrote: post #32

Medicalidiot wrote: post #7

This is to be expected. Any time we do any transplant immunosupressants are given to the recipient for the rest of their life, but this only slows the inevitable. Heart transplants recipients all get accelerated atherosclerosis. Lung transplant recipients all get long term fibrosis. We buy time with these procedures and do everything we can to keep them going, but if you have a transplant, you're in a really bad spot…

How much of this is mitigated by donor/recipient compatibility (haplotypes? is that the right word?)? Is there no such thing as a purely compatible donor?

Post by pkaye » Mon, Sep 23, 2019, 5:52 PM UTC

rcombine wrote: post #26

anon9001 wrote: post #18

> “We all know we are in uncharted waters,” Tarleton said. “I would rather not have to go through a catastrophic failure.” If anyone hasn't been through some tragic medical shit in their life, pay attention to that. You'll understand it later.

This is what gets me. Take care of yourself, because you don't know what kind of Sword of Damocles is hanging over your head.