Lung Transplant Rejection
What are the risks of transplantation?
The risks of transplantation are the same as those of any surgery. They
include
the
risk of bleeding or breathing problems. Some transplant recipients might also
experience side effects from the medicines.
The two main complications of transplant surgery are organ rejection and
infection. Since the body recognizes the new lung as a foreign object, it will
normally try to get rid of it or "reject" it. Anti-rejection drugs
taken after surgery help prevent a rejection episode, but they also inhibit
part of the immune system. Since the body's ability to fight infection is
decreased, transplant recipients are more prone to infections.
Years of experience, research, and improved medicines help prevent rejection,
and your transplant team will take every precaution to prevent these
complications. While you are recovering in the hospital, you will learn to
recognize signs of rejection and infection. What is transplant rejection?
The body's immune system protects you from infection. Immune cells recognize
the transplanted lung as different from the rest of the body and attempt to
destroy it. This is called rejection, and it is your body's way of not accepting
the new organ.
After transplant surgery, you are prescribed immunosuppressive drugs to
"fool" your immune system into thinking your new lung is your own so
it doesn't try to attack it.
Although rejection is most common in the first six months after surgery, it
can occur at any time. Fortunately, rejection can be treated, especially if
the signs of rejection are recognized early. While you are in the hospital,
your transplant team can usually recognize a rejection episode before it causes
any major or irreversible damage.
After you go home, it is vital for you to be aware of the possible signs of
rejection so you can report them to your health care providers and be treated
immediately. It is also very important for you to continuously take your
medicines as prescribed, have your blood work drawn as scheduled, and follow
your pulmonary function test and bronchoscopy schedules. What are the warning signs of possible rejection?
If you are experiencing any of these symptoms, contact your transplant
coordinator immediately:
- Fever over 100°F (38°C)
- "Flu-like" symptoms:
chills, aches, headache, dizziness, nausea and/or vomiting
- Chest congestion
- Cough
- Shortness of breath
- New pain or tenderness around
the lung
- Fatigue or generally feeling
"lousy"
How is rejection identified?
The transplant team will be able to determine if your body is rejecting your
new
lung by completing daily tests of pulmonary function during your hospital
stay. If the team thinks you might be experiencing any problems with your new
lung, the following tests might be completed:
- Repeated blood work including
a complete blood count
- Bronchoscopy
- Lung biopsy and surveillance
bronchoscopy — These tests are performed routinely as part of your follow-up care (at
three
weeks, six weeks,
three months, six months, nine months, and one year after transplant surgery)
How is rejection treated?
If rejection develops, your doctor will prescribe medicine to treat
rejection and prevent continued complications. In order to control the
rejection, you might need to be admitted to the hospital, or you might receive
care in an outpatient setting. Will rejection treatment cause side effects?
The medicines used to treat a lung rejection episode are strong drugs. The
first few doses might cause the following side effects:
- Fever, chills
- Headaches
- Nausea, vomiting
- Weakness
- Diarrhea
- General flu-like symptoms
In order to help control these symptoms, you will receive a pre-medication of
acetaminophen (Tylenol) and diphenhydramine hydrochloride (Benadryl) before
each dose.
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