HF 6796

Organ Rejection: Kidney, Liver or Pancreas Transplant

Rejection is when your body’s immune system attacks your new organ. Your body is trying to destroy it. There are two kinds of rejection. Treatment varies for each. The signs of rejection also vary for each type of organ.

Acute Cellular Rejection

This type of rejection is a direct response to your new organ. The T cells (or “killer cells”) of your immune system see your organ as foreign. A biopsy is done to diagnose this. The first treatment is high dose steroids. Starting treatment sooner improves the outcomes. If steroids do not help, you may need IV medicine in the hospital. Your doctor may also increase your anti-rejection medicines.

Acute Antibody-Mediated Rejection (AMR)

AMR is an indirect response to your new organ. The B cells (or “memory cells”) of your immune system notice the cells from the new organ. An immune response begins. The body starts to make new antibodies to fight off the new organ. Treatment includes medicines. If needed, antibodies can be removed from your blood. This process is called plasmapheresis. It is similar to dialysis. The goal is to remove antibodies that are attacking your new organ.

You may have chronic AMR if the rejection has been ongoing or the biopsy shows tissue scarring from rejection. Your doctor will review the risks and benefits of ongoing treatment. You may need more medicines and treatments.

Testing for Rejection

Lab tests are often the fastest way to catch a problem. Make sure you have your labs done as scheduled. A biopsy is needed to diagnose rejection. Other tests might include an ultrasound or scan.

Signs of Rejection

You may have signs of rejection. You will often see changes in your lab results. Other signs you might notice on your own. Call your coordinator for any of these signs.

Signs of Kidney Rejection

  • Increased creatinine

  • Increased temperature

  • Increased weight

  • Decreased urine output

  • Ankle swelling

  • Swelling or tenderness over kidney

  • Body aches

Signs of Pancreas Rejection

  • Increased lipase

  • Increased amylase

  • Increased glucose

  • Increased temperature

  • Tenderness over pancreas

  • Body aches

Signs of Liver Rejection

  • Increase in liver blood tests and/or bilirubin

  • Increased temperature

  • Jaundice – yellow color seen in skin and white part of eye (sclera)

  • Tenderness over liver site

  • Body aches