Organ Transplant – General Information An Organ Transplant means the moving of a whole or partial organ from a body to another (or from a donor on the patient’s body), in order to replace the recipient’s damaged or failing organ with a new, working one from the donor site. The organ donors can be living or deceased (also named cadaveric). There are several types of Organ Transplants that include: # Allograft – is a transplant of an organ or a tissue from a non-identical member (genetically talking) of the same species. # Autograft – is a transplant of tissue from one to oneself. This is usually done with a surplus of tissue that can regenerate or if the tissue is needed elsewhere (such as skin grafts, vein extraction for CABG (meaning Coronary artery bypass surgery). # Xenograft and Xenotransplantion – is a transplant of organs or tissue from one species to another. It is an extremely dangerous type of transplant. # Isograft – is an Organ Transplant from a donor to a genetically identical recipient (like an identical twin). # Split transplants – when there is a deceased donor organ –especially liver- it may be divided between two patients either adults or children. # Domino transplants – this is usually performed in the case of the cystic fibrosis when both lungs need to be replaced or when the heart needs to be replaced. When a patient suffers from familiar amyloidotic polyneuropathy –meaning that the liver produces some substances that damage the other internal organs- the liver may be transplanted to an elder patient who is likely to die from other causes before a problem from his liver may come up. Organ Transplant – Symptoms The immune system is the body’s defense against foreign invaders such as bacteria or viruses and unfortunately the immune system can not make the difference between an invader and a new organ, this is why rejection happens. The rejection can happen without being noticed and can be found on a normal doctor visit. Here is a list of the most common symptoms of the rejection that can appear after an Organ Transplant: # Fever over 38°C # Flu-like symptoms such as chills, nausea, vomiting, diarrhea, tiredness, headache, dizziness, or body aches and pain # pain or tenderness over your transplant site # Retaining fluids or having sudden weight gain # Shortness of breath # Sudden rise in blood pressure # Change in pulse rate The kidney transplant recipients may experience: # Change in the color or smell of urine # A lower amount of urine # Fever over 38°C # Increased blood pressure # Weight gain over 2 pounds a day # Pain over kidney The liver transplant recipients can experience the following symptoms: # Yellow color to the skin or eyes # Light-colored or blackened stools # Fever over 38°C # Fatigue # Clay colored stools # Pain over liver The pancreas transplant recipients can experience the following symptoms: # Fever over 38°C or 100.4°F # Increased blood sugars # Pain over pancreas Rejection is an ongoing concern for the Organ Transplant recipients. That is why it is very important that the patients take all of the medications, every day, exactly as prescribed after and before an Organ Transplant. Organ Transplant – Treatment After an Organ Transplant rejection may appear, rejection means that the body’s immune system attacks the transplanted organ and tries to destroy it. There are several kinds of rejection that can appear after an Organ Transplant, which need different types of treatment. The acute cellular rejection is a direct recognition of the transplanted organ. The killer cells of the immune system see the organ as a foreign. The only way to diagnose this type of rejection is by biopsy and the treatment is based on high dose of steroids. If it does not respond to this kind of treatment then there may be used a medicine named Thymo, in order to treat it and the Organ Transplant to function. Thymo (also known as Anti-Thymocyte Globulin) is used to treat and to prevent the rejection by stopping the T cells. This medicine is infused through a central line or dialysis line. The common side effects of it are the followings: # Fever # Headaches # Muscle aches # Abdomen pain # Lowered blood counts # High blood pressure # Shortness of breath # Severe symptoms may appear too, such as: infection and anaphylaxis. Before starting the treatment with Thymo patients who had an Organ Transplant usually receive acetaminophen, diphenydramine, and a steroid, and after starting the treatment the doctors will watch closely the vital signs and the blood counts, if it gets too low the dose will be adjusted. The antibody-mediated rejection, also known as humoral rejection, is an indirect recognition of the new organ. The B cells of the immune system recognize only part of cells from the transplanted organ and they start to produce new antibodies against the organ. This type of rejection may also be diagnosed after a biopsy and the treatment for it is CMV IgG, rituximab and steroids. If it does not respond to these treatments then plasmaphoresis may be needed, in order to remove the antibodies. The CMV IgG, also known as cytomegalovirus immune globulin, is used in the treatment of rejection and it work by enabling the antibodies to attack the transplanted organ. It is usually infused into the veins. The common side effects are: # Facial flushing # Chills and fever # Sweating # nausea and vomiting # Less common side effects include: anaphylaxis and low blood pressure. The dose of this medicine will be increased slowly and the vital signs watch closely by the doctors and if the side effects appear the treatment is slowed down or even stopped for a period of time. Rituximab is used to prevent and treat a rejection; it works by killing the B cells and it is infused in the veins. The common side effects include: # Fever with shaking chills # Shortness of breath # Chest heaviness # Flushing # Pain # Low blood pressure # The uncommon side effects include: decreased blood counts and nausea. Before starting the treatment with Rituximab patients who had an Organ Transplant usually receive acetaminophen and diphenhydramine and their vital signs will be closely watched by their doctors.