12.12 · Transplantation — jour 1

Transplantation — day 1

SMB4 Systèmes physiologiques 2 Immunologie, inflammation, transplantation · 61 pages

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1Title Slide 2Course Agenda

Clinical Vignette

3Patient Presentation & HLA Typing 4Donor Matching & Surgery 5Acute Rejection Episode 6Anti-Rejection Treatment & Outcome 7Transplant Pathway Summary

Genetic Barriers to Transplantation

8Four Barriers Overview 9Graft Classification

ABO Blood Groups

10Second Barrier Introduction 11Genotypes, Antigens & Antibodies 12ABO Compatibility Matrix 13ABO Antigen Sugar Structures 14Endothelial ABO & Complement Injury

Major Histocompatibility Complex

15Third Barrier Introduction 16MHC Mismatch Causes Rapid Rejection 17Chromosome 6 Gene Map 18Class I vs Class II Function 19HLA Peptide-Presentation Diagram

HLA Polymorphism

20Allele Counts (>37,000)21Polymorphism & Polygeny 22Codominant Expression 236 Class I + 6-8 Class II Molecules 24Maternal & Paternal HLA Display

Individual-Level HLA Advantage

25Virus Escape vs Recognition 26Heterozygote Advantage 27Multiple HLA-Peptide-T Cell Pairs

Population-Level HLA Advantage

28Population Diversity vs Novel Pathogen 29Each Person Has Different Alleles 30Comparing Two Individuals' HLA

Minor Histocompatibility Antigens

31Fourth Barrier Introduction 32Slow Rejection Despite MHC Match 33Definition & Y-Chromosome Example 34Human Genetic Diversity (Visual)35Molecular Diversity Illustration 36Major vs Minor Antigen Mechanism

History of Transplantation

37World Firsts (1954-1987)38Transition to Swiss Context 39Swiss Firsts (1965-2005)

Transplantation in Switzerland

40Swisstransplant Organization 41Organ Donation Networks 42Transplant Centers by Organ

Swiss Transplant Statistics

43All Organ Transplants 2020-2024 44Kidney Transplants (DBD/DCD)45Liver Transplants (DBD/DCD)46Heart Transplants (DBD/DCD)47Lung Transplants (DBD/DCD)48Pancreas/Islet Transplants 49Hematopoietic Stem Cell Transplants

50No Transplant Without a Donor 51Living vs Deceased Donors (2011-2024)52Waiting List vs Transplants (2023)53Average Waiting Times by Organ

Brain Death & Donor Criteria

54Brain Death Definition 55Brain Death Imaging 56DBD vs DCD Pathways

57Donor Exclusion Criteria

Ethical & Legal Aspects

58Religious Perspectives 59No Theoretical Age Limit 60European Donor Rates & Consent Models 61Presumed vs Explicit Consent

12.12Page 1The HLA SystemTitle Slide

Transplantation — jour 1 page 1

12.12Page 2The HLA SystemCourse Agenda

Transplantation — jour 1 page 2

12.12Page 3The HLA SystemClinical VignettePatient Presentation & HLA Typing

Transplantation — jour 1 page 3

12.12Page 4The HLA SystemClinical VignetteDonor Matching & Surgery

Transplantation — jour 1 page 4

12.12Page 5The HLA SystemClinical VignetteAcute Rejection Episode

Transplantation — jour 1 page 5

12.12Page 6The HLA SystemClinical VignetteAnti-Rejection Treatment & Outcome

Transplantation — jour 1 page 6

12.12Page 7The HLA SystemClinical VignetteTransplant Pathway Summary

Transplantation — jour 1 page 7

12.12Page 8The HLA SystemGenetic Barriers to TransplantationFour Barriers Overview

Transplantation — jour 1 page 8

12.12Page 9The HLA SystemGenetic Barriers to TransplantationGraft Classification

Transplantation — jour 1 page 9

12.12Page 10The HLA SystemGenetic Barriers to TransplantationABO Blood GroupsSecond Barrier Introduction

Transplantation — jour 1 page 10

12.12Page 11The HLA SystemGenetic Barriers to TransplantationABO Blood GroupsGenotypes, Antigens & Antibodies

Transplantation — jour 1 page 11

12.12Page 12The HLA SystemGenetic Barriers to TransplantationABO Blood GroupsABO Compatibility Matrix

Transplantation — jour 1 page 12

12.12Page 13The HLA SystemGenetic Barriers to TransplantationABO Blood GroupsABO Antigen Sugar Structures

Transplantation — jour 1 page 13

12.12Page 14The HLA SystemGenetic Barriers to TransplantationABO Blood GroupsEndothelial ABO & Complement Injury

Transplantation — jour 1 page 14

12.12Page 15The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexThird Barrier Introduction

Transplantation — jour 1 page 15

12.12Page 16The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexMHC Mismatch Causes Rapid Rejection

Transplantation — jour 1 page 16

12.12Page 17The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexChromosome 6 Gene Map

Transplantation — jour 1 page 17

12.12Page 18The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexClass I vs Class II Function

Transplantation — jour 1 page 18

12.12Page 19The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexHLA Peptide-Presentation Diagram

Transplantation — jour 1 page 19

12.12Page 20The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexHLA Polymorphism+1 more

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12.12Page 21The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexHLA Polymorphism+1 more

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12.12Page 22The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexHLA Polymorphism+1 more

Transplantation — jour 1 page 22

12.12Page 23The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexHLA Polymorphism+1 more

Transplantation — jour 1 page 23

12.12Page 24The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexHLA Polymorphism+1 more

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12.12Page 25The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexIndividual-Level HLA Advantage+1 more

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12.12Page 26The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexIndividual-Level HLA Advantage+1 more

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12.12Page 27The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexIndividual-Level HLA Advantage+1 more

Transplantation — jour 1 page 27

12.12Page 28The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexPopulation-Level HLA Advantage+1 more

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12.12Page 29The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexPopulation-Level HLA Advantage+1 more

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12.12Page 30The HLA SystemGenetic Barriers to TransplantationMajor Histocompatibility ComplexPopulation-Level HLA Advantage+1 more

Transplantation — jour 1 page 30

12.12Page 31The HLA SystemGenetic Barriers to TransplantationMinor Histocompatibility AntigensFourth Barrier Introduction

Transplantation — jour 1 page 31

12.12Page 32The HLA SystemGenetic Barriers to TransplantationMinor Histocompatibility AntigensSlow Rejection Despite MHC Match

Transplantation — jour 1 page 32

12.12Page 33The HLA SystemGenetic Barriers to TransplantationMinor Histocompatibility AntigensDefinition & Y-Chromosome Example

Transplantation — jour 1 page 33

12.12Page 34The HLA SystemGenetic Barriers to TransplantationMinor Histocompatibility AntigensHuman Genetic Diversity (Visual)

Transplantation — jour 1 page 34

12.12Page 35The HLA SystemGenetic Barriers to TransplantationMinor Histocompatibility AntigensMolecular Diversity Illustration

Transplantation — jour 1 page 35

12.12Page 36The HLA SystemGenetic Barriers to TransplantationMinor Histocompatibility AntigensMajor vs Minor Antigen Mechanism

Transplantation — jour 1 page 36

12.12Page 37The HLA SystemHistory of TransplantationWorld Firsts (1954-1987)

Transplantation — jour 1 page 37

12.12Page 38The HLA SystemHistory of TransplantationTransition to Swiss Context

Transplantation — jour 1 page 38

12.12Page 39The HLA SystemHistory of TransplantationSwiss Firsts (1965-2005)

Transplantation — jour 1 page 39

12.12Page 40The HLA SystemTransplantation in SwitzerlandSwisstransplant Organization

Transplantation — jour 1 page 40

12.12Page 41The HLA SystemTransplantation in SwitzerlandOrgan Donation Networks

Transplantation — jour 1 page 41

12.12Page 42The HLA SystemTransplantation in SwitzerlandTransplant Centers by Organ

Transplantation — jour 1 page 42

12.12Page 43The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsAll Organ Transplants 2020-2024

Transplantation — jour 1 page 43

12.12Page 44The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsKidney Transplants (DBD/DCD)

Transplantation — jour 1 page 44

12.12Page 45The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsLiver Transplants (DBD/DCD)

Transplantation — jour 1 page 45

12.12Page 46The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsHeart Transplants (DBD/DCD)

Transplantation — jour 1 page 46

12.12Page 47The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsLung Transplants (DBD/DCD)

Transplantation — jour 1 page 47

12.12Page 48The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsPancreas/Islet Transplants

Transplantation — jour 1 page 48

12.12Page 49The HLA SystemTransplantation in SwitzerlandSwiss Transplant StatisticsHematopoietic Stem Cell Transplants

Transplantation — jour 1 page 49

12.12Page 50The HLA SystemOrgan DonationNo Transplant Without a Donor

Transplantation — jour 1 page 50

12.12Page 51The HLA SystemOrgan DonationLiving vs Deceased Donors (2011-2024)

Transplantation — jour 1 page 51

12.12Page 52The HLA SystemOrgan DonationWaiting List vs Transplants (2023)

Transplantation — jour 1 page 52

12.12Page 53The HLA SystemOrgan DonationAverage Waiting Times by Organ

Transplantation — jour 1 page 53

12.12Page 54The HLA SystemOrgan DonationBrain Death & Donor CriteriaBrain Death Definition

Transplantation — jour 1 page 54

12.12Page 55The HLA SystemOrgan DonationBrain Death & Donor CriteriaBrain Death Imaging

Transplantation — jour 1 page 55

12.12Page 56The HLA SystemOrgan DonationBrain Death & Donor CriteriaDBD vs DCD Pathways

Transplantation — jour 1 page 56

12.12Page 57The HLA SystemOrgan DonationDonor Exclusion Criteria

Transplantation — jour 1 page 57

12.12Page 58The HLA SystemOrgan DonationEthical & Legal AspectsReligious Perspectives

Transplantation — jour 1 page 58

12.12Page 59The HLA SystemOrgan DonationEthical & Legal AspectsNo Theoretical Age Limit

Transplantation — jour 1 page 59

12.12Page 60The HLA SystemOrgan DonationEthical & Legal AspectsEuropean Donor Rates & Consent Models

Transplantation — jour 1 page 60

12.12Page 61The HLA SystemOrgan DonationEthical & Legal AspectsPresumed vs Explicit Consent

Transplantation — jour 1 page 61