BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuTransplant rejectionGraft rejection; Tissue/organ rejectionTransplant 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.Immune systemThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....ImageRead Article Now Book Mark Article 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.AntigensAn antigen is any substance that causes your immune system to produce antibodies against it. This means your immune system does not recognize the su...ImageRead Article Now Book Mark Article 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. Blood transfusion reactionA hemolytic transfusion reaction is a serious complication that can occur after a blood transfusion. The reaction occurs when the red blood cells th...ImageRead Article Now Book Mark Article To help prevent this reaction, doctors 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.Doctors 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 the wrong type of blood. For example, when a person is given type A blood when he or she is type B. 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 breathThe symptoms depend on the transplanted organ or tissue. For example, patients who reject a kidney may make less urine, and patients who reject a heart may have symptoms of heart failure. Exams and Tests The health care provider will examine the area over and around the transplanted organ.Signs that the organ is not working properly include:High blood sugar (pancreas transplant) Less urine released (kidney transplant) Shortness of breath and less ability to exercise (heart transplant or lung transplant) Yellow skin color and easy bleeding (liver transplant) A biopsy of the transplanted organ can confirm that it is being rejected. A routine biopsy is often performed periodically to detect rejection early, before symptoms develop.BiopsyA biopsy is the removal of a small piece of tissue for laboratory examination.Read Article Now Book Mark Article When organ rejection is suspected, one or more of the following tests may be done before the organ biopsy:Abdominal CT scan Abdominal CT scanAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Heart echocardiography Heart echocardiographyAn echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Kidney arteriography Kidney arteriographyRenal arteriography is a special x-ray of the arteries of the kidneys.ImageRead Article Now Book Mark Article Kidney ultrasound UltrasoundUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article Lab tests of kidney or liver function Treatment The goal of treatment is to improve the chances that the transplanted organ or tissue continues to work properly by suppressing your immune system response. Suppressing the immune response may prevent transplant rejection.Medicines will likely be used to suppress the immune response. Dosage and choice of medicines depends on your condition. The dosage may be very high while the tissue is being rejected. After you no longer have signs of rejection, the dosage will likely be lowered. Outlook (Prognosis) Medicines that suppress the immune system may stop the rejection. Most people need to take these medicines for the rest of their life.Single episodes of acute rejection rarely lead to organ failure.Chronic rejection is the leading cause of organ transplant failure. The organ slowly loses its function and symptoms start to appear. This type of rejection cannot be effectively treated with medicines. Some people may need another transplant. Possible Complications Health problems that may result from transplant or transplant rejection include:Certain cancers (in some people who take strong immune-suppressing medicines for a long time) Infections (because the person's immune system is suppressed by taking immune-suppressing medicines) Loss of function in the transplanted organ/tissue Side effects of medicines, which may be severe When to Contact a Medical Professional Contact your provider if the transplanted organ or tissue does not seem to be working properly, or if other symptoms occur. Also, contact your provider if you have side effects from medicines you are taking. Prevention ABO blood typing and HLA (tissue antigen) typing before a transplant helps ensure a close match. ABO blood typingBlood typing is a method to tell what type of blood you have. Blood typing is done so you can safely donate your blood or receive a blood transfusio...ImageRead Article Now Book Mark Article HLA (tissue antigen) typingA histocompatibility antigen blood test looks at proteins called human leukocyte antigens (HLAs). These are found on the surface of almost all cells...ImageRead Article Now Book Mark Article You will likely need to take medicine to suppress your immune system for the rest of your life to prevent the tissue from being rejected.Being careful about taking your post-transplant medicines and being closely watched by your doctor may help prevent rejection.Open ReferencesReferencesAbbas AK, Lichtman AH, Pillai S. Transplantation immunology. In: Abbas AK, Lichtman AH, Pillai S, eds. Cellular and Molecular Immunology. 10th ed. Philadelphia, PA: Elsevier; 2022:chap 17.Badell IR, Adams AB, Larsen CP. Transplantation immunobiology and immunosuppression. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 25.Tse G, Marson L. Immunology of graft rejection. In: Forsythe JLR, ed. Transplantation: A Companion to Specialist Surgical Practice. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 3.AllVideoImagesTogAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationRelated Information Graft-versus-host disease(Condition)Immune response(Special Topic)Hemolytic transfusion reaction(Condition) Review Date: 4/18/2023 Reviewed By: John Roberts, MD, Professor of Internal Medicine (Medical Oncology), Yale Cancer Center, New Haven, CT. He is board certified in Internal Medicine, Medical Oncology, Pediatrics, Hospice and Palliative Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. 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Transplant rejectionGraft rejection; Tissue/organ rejectionTransplant 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.Immune systemThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....ImageRead Article Now Book Mark Article 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.AntigensAn antigen is any substance that causes your immune system to produce antibodies against it. This means your immune system does not recognize the su...ImageRead Article Now Book Mark Article 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. Blood transfusion reactionA hemolytic transfusion reaction is a serious complication that can occur after a blood transfusion. The reaction occurs when the red blood cells th...ImageRead Article Now Book Mark Article To help prevent this reaction, doctors 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.Doctors 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 the wrong type of blood. For example, when a person is given type A blood when he or she is type B. 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 breathThe symptoms depend on the transplanted organ or tissue. For example, patients who reject a kidney may make less urine, and patients who reject a heart may have symptoms of heart failure. Exams and Tests The health care provider will examine the area over and around the transplanted organ.Signs that the organ is not working properly include:High blood sugar (pancreas transplant) Less urine released (kidney transplant) Shortness of breath and less ability to exercise (heart transplant or lung transplant) Yellow skin color and easy bleeding (liver transplant) A biopsy of the transplanted organ can confirm that it is being rejected. A routine biopsy is often performed periodically to detect rejection early, before symptoms develop.BiopsyA biopsy is the removal of a small piece of tissue for laboratory examination.Read Article Now Book Mark Article When organ rejection is suspected, one or more of the following tests may be done before the organ biopsy:Abdominal CT scan Abdominal CT scanAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Heart echocardiography Heart echocardiographyAn echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Kidney arteriography Kidney arteriographyRenal arteriography is a special x-ray of the arteries of the kidneys.ImageRead Article Now Book Mark Article Kidney ultrasound UltrasoundUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article Lab tests of kidney or liver function Treatment The goal of treatment is to improve the chances that the transplanted organ or tissue continues to work properly by suppressing your immune system response. Suppressing the immune response may prevent transplant rejection.Medicines will likely be used to suppress the immune response. Dosage and choice of medicines depends on your condition. The dosage may be very high while the tissue is being rejected. After you no longer have signs of rejection, the dosage will likely be lowered. Outlook (Prognosis) Medicines that suppress the immune system may stop the rejection. Most people need to take these medicines for the rest of their life.Single episodes of acute rejection rarely lead to organ failure.Chronic rejection is the leading cause of organ transplant failure. The organ slowly loses its function and symptoms start to appear. This type of rejection cannot be effectively treated with medicines. Some people may need another transplant. Possible Complications Health problems that may result from transplant or transplant rejection include:Certain cancers (in some people who take strong immune-suppressing medicines for a long time) Infections (because the person's immune system is suppressed by taking immune-suppressing medicines) Loss of function in the transplanted organ/tissue Side effects of medicines, which may be severe When to Contact a Medical Professional Contact your provider if the transplanted organ or tissue does not seem to be working properly, or if other symptoms occur. Also, contact your provider if you have side effects from medicines you are taking. Prevention ABO blood typing and HLA (tissue antigen) typing before a transplant helps ensure a close match. ABO blood typingBlood typing is a method to tell what type of blood you have. Blood typing is done so you can safely donate your blood or receive a blood transfusio...ImageRead Article Now Book Mark Article HLA (tissue antigen) typingA histocompatibility antigen blood test looks at proteins called human leukocyte antigens (HLAs). These are found on the surface of almost all cells...ImageRead Article Now Book Mark Article You will likely need to take medicine to suppress your immune system for the rest of your life to prevent the tissue from being rejected.Being careful about taking your post-transplant medicines and being closely watched by your doctor may help prevent rejection.Open ReferencesReferencesAbbas AK, Lichtman AH, Pillai S. Transplantation immunology. In: Abbas AK, Lichtman AH, Pillai S, eds. Cellular and Molecular Immunology. 10th ed. Philadelphia, PA: Elsevier; 2022:chap 17.Badell IR, Adams AB, Larsen CP. Transplantation immunobiology and immunosuppression. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 25.Tse G, Marson L. Immunology of graft rejection. In: Forsythe JLR, ed. Transplantation: A Companion to Specialist Surgical Practice. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 3.