Definition & Overview

In the past, organ failure translates to death. Today, with advancements in medical technology, the condition can be reversible. This is because organs can now be transplanted from one person to another. This procedure saves the lives of many patients with a diseased heart, lung, kidney, or liver.

However, an organ transplant also has risks and complications. One of the most common is organ rejection. This occurs when the recipient’s immune system recognises the transplanted tissue as a foreign material and attacks it. Unless treated promptly, the transplanted organ can also fail. Treatment of the condition involves the use of medications that suppress immune responses. In severe cases, the transplanted organ may have to be removed.

Causes of Condition

The immune system is designed to protect the body against foreign materials. These include bacteria and viruses. It works by destroying pathogens before they cause damage to the body.

This immune response is often what causes the rejection of organ transplants. The body recognises the transplanted tissue as foreign and sends antibodies to destroy it.

There are many ways to lessen the risk of the condition from occurring. Prior to the procedure, several matching tests are done. Better matching of the donor organ to the recipient greatly improves transplant outcomes. After the procedure, patients are given medications to suppress their immune system.

Despite numerous measures to prevent the patient’s immune system from rejecting the new organ, the condition still occurs. In some cases, the recipient’s body rejects the transplanted organ immediately after the operation. Some cases, however, take several months or even years.

If the body rejects the organ immediately after the procedure, the condition is referred to as hyperacute rejection. It is called acute rejection if it takes place between a week and three months after the operation. If it occurs later than three months after the operation, it is called chronic rejection.

The condition causes signs and symptoms. It is important for patients to be familiar with them. These must prompt them to seek medical assistance as soon as possible. When caught early, the condition can be prevented from progressing.

Key Symptoms

The signs and symptoms of the condition are usually mild at first. Most patients report a general feeling of uneasiness. Unless treated promptly, the condition can lead to organ failure. The patient will then experience more symptoms, which depend on the transplanted organ. For instance, patients with a failing kidney transplant will experience similar symptoms they had when their own kidneys began to fail. These include decreased urine output, fluid retention, fatigue, and shortness of breath. Patients with a failing heart transplant, on the other hand, will experience irregular heartbeats, reduced ability to exercise, wheezing, and a persistent cough.

Other possible symptoms are fever as well as pain and swelling of the organ and surrounding areas. Symptoms often associated with flu are also a common complaint. These include chills, shortness of breath, coughing, and nausea.

Who to See and Types of Treatments Available

Organ transplant patients are given a list of symptoms they have to look out for before they are discharged from the hospital. They are advised to seek immediate treatment if they experience any of the said symptoms.

It is important for the condition to be diagnosed and treated early. With the right treatment, the transplanted organ can be prevented from failing. Immediate treatment can also help patients avoid the possible complications of their condition. For example, patients with a failing transplanted kidney can be placed on dialysis.

Diagnosing the condition involves the use of the same tests that patients go through when their own organ starts to fail. The types of tests used depend on the involved organ. If a transplanted kidney is showing signs of failure, for example, urine and blood tests are carried out. The patient’s ability to urinate is checked as well. A biopsy of the organ is also often needed. This test can confirm any damage.

The majority of cases are due to the patient’s immune response to foreign materials. As such, treatment often focuses on suppressing the immune system. Immunosuppressants are prescribed as soon as the organ is transplanted. Initially, patients are prescribed high doses of the said medications. The dosage can be adjusted based on how the patient’s immune system reacts to the drugs.

Hyperacute and chronic rejections are often irreversible. Because most cases do not respond well to treatment, doctors often remove the transplanted tissue immediately. This means that the patient will require another donor organ. Acute rejection is often managed with medications. Despite the available treatment, rejection remains to be the major cause of transplant failure.

References:

  • Baldwin WM 3rd, Valujskikh A, Fairchild RL. Mechanisms of antibody-mediated acute and chronic rejection of kidney allografts. Curr Opin Organ Transplant. 2015 Nov 14.

  • Willicombe M, Brookes P, Santos-Nunez E, et al. Outcome of patients with preformed donor-specific antibodies following alemtuzumab induction and tacrolimus monotherapy. Am J Transplant. 2011 Mar. 11(3):470-7.

  • Belliere J, Kamar N, Mengelle C, Allal A, Sallusto F, Doumerc N, et al. Pilot conversion trial from mycophenolic acid to everolimus in ABO-incompatible kidney-transplant recipients with BK viruria and/or viremia. Transpl Int. 2015 Nov 17.

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