What Is a Transplant Rejection?
Transplant rejection occurs when the body does not accept the transplanted organ or body part. Rejection can happen in the first six months following the transplant surgery or many years after the transplant. The healthcare providers involved in the transplant procedure can identify the chances of rejection beforehand and treat it before the rejection. Also, it is important to take medicine and go for follow-ups at regular intervals, as advised by the doctor.
What Are the Causes of Transplant Rejection?
The body is defended against harmful organisms like germs, poisons, and sometimes cancer cells by the immune system. These have certain proteins on their surface called antigens. When these antigens enter the body, the body's immune system reacts against them by identifying them as foreign substances. The duty of the immune system is to fight against foreign substances by identifying the antigens on them. Similarly, the body's immune system recognizes organs as foreign objects when a person receives an organ from another.
This occurs when the antigen over the organ's cells is identified as different from the body's other cells; hence, the body reacts against it to destroy it. Hence the mismatched organs trigger blood transfusion reaction or transplant rejection. The doctors give medicines to suppress the body's immune system. There are some exceptions to rejection, like the corneal transplant, as the cornea has no blood supply, and a transplant from an identical twin is rarely rejected.
What Are the Types of Transplant Rejection?
The are different types of organ rejection, and they are:
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Acute Rejection - Acute rejection occurs anytime from the first week after the transplant to three months following the transplant.
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Chronic Rejection - Chronic rejection can happen many years after the transplant. The body's immune response for a long time will damage the transplanted organ. This kind of rejection can be antibody-mediated as well as cell-mediated. Immunosuppressive drugs and tissue typing have decreased the chance of transplant rejection, but chronic rejection cannot be fully prevented.
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Hyperacute Rejection - This typically occurs within a few minutes after the transplant as the antigens are completely unmatched. In such cases, the transplanted organ should be removed immediately; otherwise, the recipient will die. This type of rejection is seen when the recipient receives the wrong blood type. This rejection is mediated through blood because the receiver already has the antibodies against the graft, which may be from a prior blood transfusion, multiple pregnancies, or previous transplants. As a result, the antigen-antibody reaction occurs, resulting in the formation of massive thrombosis in the vessels, preventing the vascularization of the graft. Hyperacute rejection is most commonly seen in transplanted kidneys, and the liver is the least susceptible to it because of its dual blood supply.
What Are the Signs and Symptoms of Transplant Rejection?
The signs and symptoms of transplant rejection are:
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Decreased functioning of the organ.
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Feeling unwell, tired, or uneasy.
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Swelling in the area of the organ.
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Pain in the organ.
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Fever.
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Body pain, shivering, nausea, cough, or breathing difficulty.
The transplant rejection symptoms depend on the organ or tissue transplanted. For example, patients with kidney transplants have decreased urine output, and patients with heart rejection may have symptoms of heart failure.
Signs of transplant rejection include:
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High blood sugar in pancreas transplant.
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Shortness of breath and less exercise tolerance in a heart transplant or a lung transplant rejection.
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Less urine is released after a kidney transplant.
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Yellow skin color and easy bleeding after a liver transplant.
What to Do to Avoid Transplant Rejection?
To get the best results, the patient must follow the below-mentioned instructions:
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The patient must take his medication for the prescribed period and should never miss a dose.
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Go for follow-up checkups.
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Go for all the appointments.
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Do all the necessary laboratory tests.
Avoid Infections
Infections do not cause organ rejection but can increase the chances of organ rejection, especially when the medicines can compromise the immunosuppressants.
It is important to take care to avoid infections and to keep the transplanted organ healthy. Hand washing, taking required vaccinations, taking safe food, and following all the instructions by the doctor to avoid transplanted organ rejection.
How Is Transplant Rejection Diagnosed?
When transplant rejection is suspected, the healthcare worker will advise the following tests before the organ biopsy:
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Chest X-ray.
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Abdominal CT scan.
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Echocardiography.
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Kidney arteriography.
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Kidney ultrasound.
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Other blood and laboratory tests.
How Is Transplant Rejection Treated?
The success of the transplant is when we decrease the chance of rejection. So the treatment goal is to make the transplanted organ or tissue function properly and suppress the recipient's immunity. The recipient needs to take medicines to reduce transplant rejection. The dosage and the medicine will depend upon the condition. When there are signs of tissue rejection, the dosage of the medicines will be high and gradually decrease when the signs no longer exist.
What Are the Complications?
Certain health problems may occur as a result of transplant rejection, and they are
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Cancers.
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Infections.
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Side effects of the medicines.
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Loss of function of the transplant failure organ.
How Is the Prognosis?
The success of the transplant will vary according to the organs. When the rejection begins, the medicines that suppress the immunity will eventually stop the rejection. After undergoing a transplant, most people need immunosuppressants for the remainder of their life. The medicines can avoid rejection to some extent only by suppressing immunity, and the transplanted organ can fail.
Single acute episodes of rejection will rarely lead to organ failure, whereas chronic rejection is the main cause of organ transplant failure. The organ's functioning gradually decreases, and the symptoms will start to appear. This type of rejection cannot be treated with medicines. As a result, few people may even need another transplant.
Conclusion
Transplant procedures are often done as a last resort to save lives and can successfully save lives if the transplanted organ is not rejected. Transplant rejection can occur due to various reasons. The body's immune system can be a savior but sometimes a hurdle in conditions like transplants, where they initiate rejection. A person who underwent a transplant should be careful for the rest of their life and follow the doctor's instructions verbatim.
