Rejection episodes are unpredictable in frequency and severity. Almost everyone will experience one or more episodes at some time after their operation. To minimise the risk it is important that you take your medicines every day in the exact way you have been taught. Rejection can be classified as acute, chronic or antibody mediated.
Diagnosis of rejection
To help detect rejection before you experience obvious symptoms, you will undergo a series of routine examinations and investigations at set intervals after the transplant, usually as an outpatient.
These may include a combination of the following:
- physical examination
- review and history of symptoms
- blood tests
- x rays
- CT scans
- function testing
Chronic rejection describes certain changes that can develop in the transplanted organ usually over a period of six months to many years. In the instance of lungs it can appear as early as six months after the operation.
Although chronic rejection can be treated, it cannot be cured.
Antibody Mediated Rejection
Antibody mediated rejection is when the body produces antibodies to your transplanted organ. Antibodies are proteins made by your body to fight infection or foreign substances. Immunadsorption (also known as plasmapheresis) is a treatment for antibody mediated rejection. This treatment involves removing anti-bodies from the blood using a treatment similar to dialysis. Blood is withdrawn from the body, anti coagulated (thinned) and then separated by a machine into red blood cells and plasma.
Antibodies are found in plasma, so when the plasma is passed through specialised equipment (called absorption columns) the anti-bodies are removed. The 'cleaned' equipment (called adsorption columns) the anti-bodies are removed. The 'cleaned' plasma is then mixed back together with your red blood cells and returned to your body.
Immunoadsorption is normally a painless treatment and usually causes few, if any, side effects. You should be able to eat and drink normally throughout the treatment. Each treatment takes approximately 4-5 hours. The number of treatments required will vary according to individual needs.