What is Transplant Rejection

Transplant rejection occurs when your body defense (immune) system attacks the new organ or tissue that you received from a transplant. Transplant rejection can cause severe damage to or death of the transplanted organ or tissue. There are three types of transplant rejection:

• Hyperacute rejection. This occurs moments after a transplant.
• Acute rejection. This occurs between the first week and 3 months after the transplant.
• Delayed rejection. This occurs any time after the first 3 months and can happen years or decades after the transplant.

What are the causes?

The surfaces of all the cells in your body contain markers called antigens. A transplanted organ or tissue has to have antigens that “match” your antigens. If the antigens of the transplanted organ or tissue are too different from your body’s antigens, rejection can occur. This causes your body’s immune system to attack the tissue in the same way it would attack a virus or bacteria.

What increases the risk?

The following factors may make you more likely to experience transplant rejection:

• Receiving an organ or tissue that does not match your antigens.
• Missing doses of the daily medicines that you must take after receiving an organ transplant.
• History of previous organ rejection.

What are the signs or symptoms?

General symptoms of this condition include:

• Severe fatigue.
• Weakness.
• Fever.
• Abdominal pain.
• Flu-like symptoms.
• Sudden, unintentional weight gain or obvious swelling of your ankles, hands, or feet.

Organ-specific symptoms include:

• Low urine output, weight gain and swelling, and high blood pressure due to kidney rejection.
• Shortness of breath, difficulty exercising, and weight gain and swelling due to heart or lung rejection.
• High blood sugar levels due to pancreas rejection.
• Yellow skin (jaundice), easy bruising, and easy bleeding due to liver rejection.

How is this diagnosed?

This condition is diagnosed based on your medical history and symptoms, a physical exam, and tests, which may include:

• Blood and urine tests to check the function of the transplanted organ.
• Imaging tests, such as:
  • X-rays.
  • Ultrasounds.
  • CT scans.
• Biopsy. This is when a small piece of the transplanted organ or tissue is removed and examined in a lab for signs of rejection.

How is this treated?

After having a transplant, you are prescribed medicine to prevent rejection. However, if transplant rejection is diagnosed, your health care provider may have you take higher doses of this medicine to stop the rejection. Your health care provider may also have you take different medicines to stop your immune system from rejecting the transplanted tissue or organ.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Follow any dietary instructions carefully, including when to restrict or avoid certain foods.
• Use sunblock daily.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Take all of your medicines exactly as told by your health care provider. Missing even one dose can put you at risk for transplant rejection.

Contact a health care provider if:

• You unexpectedly gain weight or have swelling.
• You have a bloated feeling or pain in your abdomen.
• You have a new cough.
• You cough up green or yellow sputum.
• You develop nausea, vomiting, or diarrhea.
• You bruise easily.
• Your skin looks yellow.
• You bleed more than normal after minor injury, your gums bleed more than usual when you floss, or you have sudden nosebleeds.
• You have a new rash.
• You have a new mole or skin growth.

Get help right away if:

• You have bleeding that will not stop.
• You are short of breath.
• You have chest pain.
• You are not producing any urine.
• You have a terrible headache that will not go away.
• You develop double vision.

Summary

• Transplant rejection occurs when your immune system attacks the new organ or tissue that you received from a transplant.
• There are a number of general symptoms such as fatigue, weakness, and fever. Some symptoms may vary according to the organ that you received.
• After having a transplant, you are prescribed medicine to prevent rejection. Take all of your medicines exactly as told by your health care provider. Missing even one dose can put you at risk for transplant rejection.