Transplant rejection remains the commonest complication after the kidney transplant procedure. Learning the symptoms of rejection, following the instructions of the healthcare provider like the Nephrologist in Karachi and taking the antirejection medication is one way to stay ahead of the long-lasting damage. Read on to know more about kidney transplant rejection:

What is transplant rejection?

In the transplant procedure, a kidney taken from the donor is placed in your body to do the job of the damaged kidneys. Once the new kidney is placed in the body, your immune system recognizes it as foreign tissue and—attacks it. This process is prevented by suppressing the immune system with the help of medication called immunosuppressants. These strong medications attenuate the normal response of the immune system, thereby preventing rejection. 

What are the types of transplant rejection?

The subtypes of rejection are:

-Sub-acute rejection: this type of rejection is recognizable by the surgeon during the transplant procedure. 

-Acute rejection: can occur anytime during the first year after surgery. This type of rejection is commonly treatable. 

-Chronic rejection: is a slow process, occurring over a period of time. The pathophysiology of this type of immune response is not understood well and therefore, is difficult to treat. 

What are the warning signs and symptoms?

You will be taught by your transplant team to recognize the signs and symptoms of transplant rejection. The team should be contacted immediately if there is: fever more than 100 °F, new onset of pain, flu-like symptoms, retention of fluid and sudden weight gain over a period of 24 hours, sudden decrease in the urine output, and increase in serum creatinine. These are the warning symptoms that warrant immediate hospital admission and a full workup.

How to identify rejection?

Apart from the warning symptoms, scheduled appointments help to stay ahead of possible organ rejection. Three-month, six month, and twelve month scheduled checkups with renal ultrasound, blood work and kidney biopsy help the transplant team identify problems with the transplanted kidney. The latter involves taking a sample from the transplanted kidney—through a long needle—and looking at the tissue under the microscope.  

What are the types of anti-rejection medication?

The three main groups of anti-rejection medication are: 

Induction agent: these types of drugs are power anti-rejection agents and are used before the transplant procedure, or immediately thereafter.

Rejection agent: these drugs are used in case of a rejection episode.

Maintenance agent: these are the drugs you will be prescribed for daily intake as maintenance therapy. Even a single dose of maintenance immunosuppressant drugs should not be missed.  

How to take the anti-rejection medication?

Maintenance therapy should be part of the daily routine, which is why you should set alarms or reminders if need be. If you have trouble taking the medication or with the regime, inform your transplant team during the follow-up care. 

If a doctor other than the transplant team prescribes a drug, the team should be informed before taking it, as the latter may interfere with the anti-rejection medication. Most importantly, the immunosuppressants should be taken even if you feel great and don’t feel the need to take them. Feeling okay just means the medication is working, and is no reason to stop or skip them. Even missing a single dose may end up causing organ rejection.  

What are the side-effects of anti-rejection medication?

Immunosuppressants are laden with side-effects i.e. more reason for follow-up care. Your transplant team will monitor the levels of the medication during the follow-up care, and in case of side effects, they may change the frequency or dosage of these drugs. An appointment with the specialist can be booked at oladoc.com.