In some kidney transplants Hyperacute graft rejection is seen . It is due to
**Core Concept**
Hyperacute graft rejection is a severe and instantaneous form of kidney transplant rejection, occurring within minutes to hours after transplantation. It is primarily caused by the presence of pre-existing antibodies against the donor's human leukocyte antigens (HLA) or other blood group antigens, leading to an immediate immune response and rejection of the transplanted kidney.
**Why the Correct Answer is Right**
The correct answer is related to the immune response against the donor's HLA or ABO blood group antigens. This is mediated by pre-formed antibodies in the recipient's blood, which are produced in response to previous exposure to the donor's antigens. The presence of these antibodies leads to activation of the complement system, causing endothelial damage, platelet activation, and subsequent thrombosis within the graft vessels, resulting in graft failure.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not relate to the immune response against the donor's HLA or ABO blood group antigens. While it may be related to other forms of rejection, it is not the primary cause of hyperacute graft rejection.
**Option B:** This option is incorrect as it refers to a different form of rejection, which is mediated by a cellular immune response rather than antibodies. It is a more common form of rejection, but not the cause of hyperacute graft rejection.
**Option C:** This option is incorrect as it is a treatment option for preventing rejection, rather than the cause of hyperacute graft rejection. Immunosuppressive drugs are used to prevent the immune response against the donor's antigens.
**Option D:** This option is incorrect as it is a type of antibody-mediated rejection, but it is not the primary cause of hyperacute graft rejection. It is a more chronic form of rejection.
**Clinical Pearl / High-Yield Fact**
In cases of hyperacute graft rejection, the presence of pre-formed antibodies against the donor's HLA or ABO blood group antigens can be identified using serological tests, such as the panel reactive antibody (PRA) test. This is a critical factor in determining the compatibility of the donor and recipient before transplantation.
**Correct Answer:** D. Antibody-mediated rejection