question for dialysis/renal care nurses

  1. Tell me what you know about organ rejection, please. I have a cousin who recently had a kidney trransplant and this is not an area of nursing that I understand very well.
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    Joined: Apr '02; Posts: 4,738; Likes: 104


  3. by   Dialyzin' Dar
    I am a former transplant patient-- my kidney rejected after 3 years. I have MPGN, and the disease attacked the transplant. The kidney also had a weak spot in the artery, and when it rejected, it blew up with blood and turned into jelly-- a pretty spectacular mess requiring vacuuming. (And 2 units of blood right after surgery for me.) Luckily, I have no antibodies from the rejection. (As you might guess, I am not too keen on another transplant!)

    Organ rejection can be from any number of things-- recurring kidney disease, viral or bacterial infections, improper dosage of immunosuppressors, injury or patient non-compliance with medications. Or the kidney might not have been a good enough match in the first place. Trying to get the medication dosages right is difficult and requires regular blood testing, and even something as simple as weight gain can impair the effectiveness of the immunosupressors. I've been through both transplant and dialysis, and for me, dialysis is much simpler and has fewer side-effects. Good communication between doctor and patient is essential-- I didn't have that, and it made everything tougher.
  4. by   heart queen
    Ditto what Dialyizin' Dar says.

    Also not only is medication noncompliance DEADLY, rejection is possible with the compliant pt. as well. Just taking the anti-rejections does not give "immunity".

    Our heart transplants undergo tissue biopsy to test for rejection. I'm pretty sure this is done with other organs as well. Any one help here? The biopsy and am lab levels are how we dose the tacro and other meds.

    Hope this helps, wishing your family well through this.
  5. by   heart queen
    Oh, forgot to add that many transplant centers offer "support group" meetings which include any family that is involved and cares... maybe this is available to you?

    Ours teaches about the process, meds, involves pt. through all stages of the process and their family. There is illness coping discussion here too!
  6. by   talaxandra
    Because the tissue type of the transplanted organ isn't the same as the reciipient's, the immune system recognises it as foreign and attacks. Immunosuppressants dampen the immune response, with the intent that the immune system won't recognise the 'otherness' of the transplanted organ.
    There are two kinds of rejection, broadly speaking: acute, which happens in the first few days post-op, and chronic, which can occur at any time. Close compliance with anti-rejection meds is vital but, as heart queen said, that doesn't mean an organ won't reject.
    In renal transplantation, at least here (Australia) there are two kinds of tests to check on the kidney's health - MAG3 scans (in the first few weeks and therefater as needed) which look at blood flow to and within the kidney, and monitoring urea and creatinine levels.
    Hope this helps!