After a renal transplant, the rejection that occurs within minutes is called?

AIIMS Patna NO - 2020

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Patna NO - 2020

Explanation

Hyperacute rejection is defined by its extremely rapid onset, occurring within minutes to hours after the transplant surgery is completed.
This immediate rejection is a humoral response, caused by pre-existing antibodies in the recipient's circulation that recognize and attack antigens on the donor organ.
The antibody-antigen reaction activates the complement system, leading to thrombosis, ischemia, and rapid, irreversible failure of the graft.

Option B: Chronic rejection is a long-term process that develops over months to years, not minutes. It involves a slow, progressive decline in organ function.
Option C: Acute rejection occurs much later than hyperacute rejection, typically developing from a few days to a few months after the transplant.
Option D: Sub-acute rejection is not a standard, distinct classification for transplant rejection. The primary categories are hyperacute, acute, and chronic. This term is used as a distractor.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types and timeframes of renal transplant rejection as background academic context rather than a clinical decision trigger.
The primary method to prevent hyperacute rejection is through pre-transplant crossmatching, where the recipient's serum is tested against the donor's lymphocytes to detect any pre-formed antibodies. A positive crossmatch is a contraindication to transplantation.
Nurses play a critical role in monitoring for early signs of rejection. For hyperacute rejection, this involves observing the organ during surgery (it will appear cyanotic and mottled) and immediate post-op monitoring for anuria.
What if? - If a patient develops fever, graft tenderness, and a rising serum creatinine level 10 days post-transplant, the most likely diagnosis is acute rejection. This situation requires an urgent graft biopsy and initiation of high-dose immunosuppressive therapy, not immediate surgical removal of the graft as in hyperacute rejection.

How to Approach the Question

First, identify the key temporal indicator in the question stem, which is 'within minutes'.
Recall the different types of transplant rejection and their characteristic onset times.
Match the timeframe 'within minutes' to the correct type of rejection. Hyperacute rejection is the only type that occurs this rapidly.
Systematically eliminate the other options based on their timeframes: Acute rejection occurs in days to months, and chronic rejection occurs in months to years.
Recognize that 'Sub-acute rejection' is not a standard category and is likely a distractor.

Concept Tested & Keywords

Q_4_ydSfN3X-Y9ZiKfGLQ6

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 1 (1-214) p. 149-151

E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 83-85