Forecast | Rejection reaction

Forecast

The prognosis after organ transplantation promises a higher life expectancy than if the original, more and more functionless organ is left in place. About 60% of heart transplant patients live with the donor organ for more than ten years. Lung transplant patients also benefit from a higher life expectancy of several years.

They often experience a significantly improved physical and mental quality of life. The prognosis after liver transplantation promises a liver function rate of 80% after 5 years and 70% after 10 years. The function rate after one year of kidney transplantation is 85%.

On average, the function of the transplanted kidney lasts 15 years. The prognosis after stem cell transplantation has been shown to prolong life in certain cancers. This is particularly true for forms of acute leukaemia.

In general, the prognosis is strongly dependent on the following factors: underlying and concomitant diseases, general condition and secondary diseases. A chronic rejection reaction cannot be completely prevented despite lifelong immunosuppressive therapy. The persistent, highly inflammatory processes can lead to a deterioration of organ function over time.

Causes

Our body’s own immune system protects our body from foreign substances by destroying and killing intruders. The so-called T-cells play a special role in this context. They belong to the group of white blood cells and have special surface proteins (antigens).

Antigens are receptors that recognise and bind characteristics of other cells. However, the T cells are not only activated in this way, but also by further signals from the foreign substance. The activated T-cells release certain messenger substances, which in turn transmit the impulse to other cells of the immune system to fight the foreign substance. So-called cytokines contribute to maintaining and strengthening the immune response, while chemokines act as a kind of attractant for other inflammatory cells. Immunosuppressive drugs intervene in this form of communication between the immune cells and prevent the natural response to the foreign cells.

Rejection after liver transplantation

Liver transplantation can be accompanied by some typical complications. In addition to the usual risks of a surgical intervention (wound infection, development of thrombosis), the primary functional loss of the transplanted liver after the operation is one of the most decisive early complications. In the worst case, this situation may result in the emergency of a new transplantation.

In the context of a rejection reaction, certain warning signals occur which should be taken seriously. These include significant exhaustion, physical weakness, loss of appetite and an increase in body temperature above 37.5°C for several hours. Other typical symptoms are abdominal pain, light brown stools and dark coloured urine. In addition, a yellowing of the skin and the white of the eyes (jaundice) can often be observed.