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A 55-Year-Old Man with End-Stage Hepatitis C Virus Infection Undergoes

Question 34

Multiple Choice

A 55-year-old man with end-stage hepatitis C virus infection undergoes orthotopic liver transplantation from a deceased donor.  The patient has no perioperative complications and is discharged from the hospital on appropriate immunosuppressant medications.  One week after the surgery, he develops nausea, vomiting, abdominal pain, and bloody diarrhea.  Physical examination shows a painful maculopapular rash over his neck, back, and extremities that extends to the palms and soles.  Endoscopic evaluation reveals multiple ulcerations of the intestinal mucosa.  Which of the following is the most likely cause of this patient's current condition?


A) Graft B cell sensitization against host MHC antigens
B) Graft T cell sensitization against host MHC antigens
C) Host B cell sensitization against graft MHC antigens
D) Host T cell sensitization against graft MHC antigens
E) Preformed antibodies against graft ABO antigens

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