Organ transplantation, unlike blood transfusion, involves major surgery, the use of drugs to suppress the immune system (immunosuppressants, including corticosteroids), and the possibility of infection, transplant rejection, and other serious complications, including death.
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.
Organ rejection is a constant threat. Keeping the immune system from attacking your transplanted organ requires constant vigilance. So, it's likely that your transplant team will make adjustments to your anti-rejection drug regimen.
1) Is the body a commodity? Can it be bought? 2) How should decisions be made on distributing scarce organs? 3) When several healthy organs are available, should they all go to one person or should several needy people each receive just one?
Disadvantages — Kidney transplantation is a major surgical procedure that has risks both during and after the surgery. The risks of the surgery include infection, bleeding, and damage to the surrounding organs. Even death can occur, although this is very rare.
Risks of transplantation
Disease-free survival rates depend on various aspects, including disease stage and degree of HLA matching between donor and patient. Infection: the risk of infection is increased after transplantation because the patient's immune system is weak.
Graft rejection occurs when the recipient's immune system attacks the donated graft and begins destroying the transplanted tissue or organ. The immune response is usually triggered by the presence of the donor's own unique set of HLA proteins, which the recipient's immune system will identify as foreign.
In most cases, adaptive immune responses to the grafted tissues are the major impediment to successful transplantation. Rejection is caused by immune responses to alloantigens on the graft, which are proteins that vary from individual to individual within a species, and are thus perceived as foreign by the recipient.
Some of the reasons may be beyond your control: low-grade inflammation from the transplant could wear on the organ, or a persisting disease or condition could do to the new organ what it did to the previous one. If you're young, odds are good you'll outlive the transplanted organ.
To reduce the chances of transplant rejection and loss of a transplant, the following steps are taken before transplantation occurs: Ensure recipient and donor have compatible blood types. Perform genetic testing to ensure compatible recipient and donor matches.
Immediate, surgery-related risks of organ donation include pain, infection, hernia, bleeding, blood clots, wound complications and, in rare cases, death. Long-term follow-up information on living-organ donors is limited, and studies are ongoing.
Chronic Rejection
This is the most common reason that kidney transplants fail. It is the long-term damage done by the body's immune system for a lot of different reasons.
Recipients of transplanted organs take anti-rejection medications to suppress their immune system and prevent it from rejecting the new organ. A suppressed immune system—one that has fewer white blood cells—raises the risk of getting infections and having difficulty fighting them.
Foods to avoid after transplant include: Raw seafood like clams, oysters, sushi and ceviche. Raw, rare or undercooked meat, poultry and fish. Raw or undercooked eggs.
Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the wait-list an increase in the number of donors is necessary.
Rejection happens in between 10 to 15 in every 100 patients during the first year after a kidney transplant. Some patients have a higher risk of rejection than others. If you have had a previous transplant, a blood transfusion, or a pregnancy you may have produced defence proteins ('antibodies').
Kidneys That Stop Working Stay Put
Surgeons typically don't remove the recipient's native kidneys—unless they're greatly enlarged or causing severe problems, such as high blood pressure or infection. “The nonfunctioning kidneys just get smaller over time,” notes Dr. Gelb.
The kidney transplant is placed in the front (anterior) part of the lower abdomen, in the pelvis. The original kidneys are not usually removed unless they are causing severe problems such as uncontrollable high blood pressure, frequent kidney infections, or are greatly enlarged.
Summary: A typically 'mild' respiratory virus can turn into deadly pneumonia in the vulnerable population of transplant patients, pointing to a need for effective medication and better prevention.
Main causes of death
Cancer (N = 57, 19.1%), graft rejection (N = 55, 18.4%) and infections (N = 52, 17.4%) were the most frequent causes of death overall, with variations between different transplanted organs (Fig 1).
Chronic rejection has widely varied effects on different organs. At 5 years post-transplant, 80% of lung transplants, 60% of heart transplants and 50% of kidney transplants are affected, while liver transplants are only affected 10% of the time.
Anti-inflammatory (NSAID) medicines such as ibuprofen (Advil®, Motrin®) naproxen (Aleve®, Naprosyn®) and aspirin (taken above the one tablet a day dose) can be harmful to your kidneys when you are on anti-rejection medicine. Do not exceed the dose on the package or the dose recommended by the transplant team.
Even with the use of immunosuppressants, your body can at times recognize your transplanted organ as a foreign object and attempt to protect you by attacking it. Despite immunosuppression medications, 10-20% of patients will experience at least one episode of rejection.