Rejection after kidney transplantation

The acute rejection reaction after kidney transplantation is accompanied by typical symptoms that indicate a deterioration in kidney function and the activity of the body’s immune system. These include exhaustion, an increase in body temperature to over 37.5°C for several hours, loss of appetite, reduced urination and edema formation (water retention in the tissue) as well as pain in the kidney area. In contrast, a chronic rejection reaction can remain clinically unremarkable for a long time.

Regular checks of laboratory parameters as well as urine tests play an important role because an increasing loss of function can be diagnosed more quickly in this way. Only the removal of tissue by biopsy can confirm the suspected diagnosis of a rejection reaction. This is often due to immunological damage to the renal corpuscles, as a result of which more protein is excreted with the urine.

In addition to an increased risk of infection as a result of immunosuppression, patients experience a number of complications after lung transplantation, most of which are easily treatable. The most common complication is a narrowing (stenosis) at the junction between the patient’s airways and the donor lung. This usually occurs within a period of between two and six months.

The narrowing is widened with the help of a balloon or stent implantation. A further complication is acute rejection after lung transplantation. It typically shows the following symptoms, which should be seen as warning signs: exhaustion, fatigue, a body temperature of more than 37.5°C for several hours and respiratory symptoms.

The latter include persistent shortness of breath despite little or no physical exertion and persistent irritation of the throat. If a rejection reaction is suspected, an X-ray examination and a bronchoscopy to obtain lung tissue by biopsy are performed immediately. If the suspicion is confirmed, the rejection reaction can usually be treated without difficulty.

Rejection after heart transplantation

One to two weeks after the heart transplantation, particularly strict hygiene regulations must be observed, as the patient receives immunosuppressive drugs in high dosages. The risk of rejection is greatest a few months after the operation. The risk of chronic rejection is mainly due to the increasing narrowing of the coronary vessels caused by deposits and excessive cell growth.

Tiny tissue extractions on the inside of the muscle, so-called biopsies, are carried out at the beginning of the procedure. The first biopsy is performed a few days after the procedure. About a year later, the coronary vessels are examined in a heart catheter.

In addition to the specially performed control measurements (weight, blood pressure, temperature, etc. ), the family doctor regularly checks the heart function by means of ultrasound, blood tests and ECG. The following symptoms should be taken seriously: A feeling of exhaustion, rapid fatigue, an increase in body temperature above 37.5°C for a few hours, shortness of breath during low physical exertion, edema formation (water retention in the tissue) and, as a result, rapid weight gain and cardiac arrhythmia.