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== Hyperacute == * Minutes to days * Occurs due to high level pre-formed anti blood group or anti-HLA antibodies binding to endothelium of the graft (antibody-mediated reaction). Initiates a cascade of events culminating in vascular thrombosis and ischaemic necrosis of the graft. * Severe, untreatable, thrombotic reaction * Very rarely seen in modern times due to screening * Assessed by screening serum against a panel of regional donors ** Non-sensitised patient = 0% ** Sensitized = 100% and will need desensitization therapy * Near-universal graft loss, can try plasmapheresis and Ig infusion if diagnosis is made early * Preventable with typing, AB screening and cross-match
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