Organ Transplant

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Transplant rejection is a process in which a transplant recipient's immune system attacks the transplanted organ or tissue.

Causes

Your body's immune system usually protects you from substances that may be harmful, such as germs, poisons, and sometimes, cancer cells.

These harmful substances have proteins called antigens coating their surfaces. As soon as these antigens enter the body, the immune system recognizes that they are not from that person's body and that they are foreign, and attacks them.

When a person receives an organ from someone else during transplant surgery, that person's immune system may recognize that it is foreign. This is because the person's immune system detects that the antigens on the cells of the organ are different or not "matched." Mismatched organs, or organs that are not matched closely enough, can trigger a blood transfusion reaction or transplant rejection.

To help prevent this reaction, health care providers type, or match both the organ donor and the person who is receiving the organ. The more similar the antigens are between the donor and recipient, the less likely that the organ will be rejected.

Tissue typing ensures that the organ or tissue is as similar as possible to the tissues of the recipient. The match is usually not perfect. No two people, except identical twins, have identical tissue antigens.

Providers use medicines to suppress the recipient's immune system. The goal is to prevent the immune system from attacking the newly transplanted organ. If these medicines are not used, the body will almost always launch an immune response and destroy the foreign tissue.

There are some exceptions, though. Cornea transplants are rarely rejected because the cornea has no blood supply. Also, transplants from one identical twin to another are almost never rejected.

There are three types of rejection:

  • Hyperacute rejection occurs a few minutes after the transplant when the antigens are completely unmatched. The tissue must be removed right away so the recipient does not die. This type of rejection is seen when a recipient is given an organ that is a different blood type. For example, when a person is given an organ that is type A blood when he or she has type B blood.
  • Acute rejection may occur any time from the first week after the transplant to 3 months afterward. All recipients have some amount of acute rejection.
  • Chronic rejection can take place over many years. The body's constant immune response against the new organ slowly damages the transplanted tissues or organ.

Symptoms

Symptoms may include:

  • The organ's function may start to decrease
  • General discomfort, uneasiness, or ill feeling
  • Pain or swelling in the area of the organ (rare)
  • Fever (rare)
  • Flu-like symptoms, including chills, body aches, nausea, cough, and shortness of breath

The symptoms depend on the transplanted organ or tissue. For example, people who reject a kidney may make less urine, and people who reject a heart may have symptoms of heart failure.