Learning About the Signs and Symptoms of Organ Rejection After a Transplant

Organ rejection is when your immune system attacks a transplanted organ. It's most common early, but can happen anytime. Watch for fever, pain or swelling, trouble breathing, less urine, sudden weight gain, or yellow skin or eyes.

What is organ rejection?

Organ rejection happens when the body's immune system attacks an organ that has been transplanted. Your immune system protects you from infection, disease, and foreign matter. So your immune system may attack the donor organ because it doesn't match your own tissue exactly.

The health problems caused by organ rejection can range from mild to very serious.

When can organ rejection happen?

Organ rejection is most common in the first few weeks or months after a transplant. But rejection can happen at any time. It may occur right after a transplant, although that's not common. It can also happen years after a transplant. This can happen, for example, with a lung transplant.

Taking antirejection medicines as directed and getting regular follow-up care are very important steps to prevent organ rejection.

How common is it?

Organ rejection is fairly common. But it varies depending on the organ that was transplanted. For example, lung rejection is more common than kidney rejection. Scientists are always working to reduce the risk of organ rejection.

What are the signs and symptoms?

Some people who are going through organ rejection notice symptoms, but others don’t. Symptoms are things that you notice or feel. Signs are things your doctor may notice or that tests can find. After a transplant, it’s very important to have follow-up visits and tests. These can help find signs and symptoms of organ rejection.

Signs and symptoms of organ rejection may include:

  • General discomfort, uneasiness, or feeling ill.
  • Flu-like symptoms. These include very low energy, chills, body aches, nausea, low appetite, a cough, and feeling like it’s hard to breathe.
  • Fever.
  • Pain, swelling, or tenderness in the area of the transplant.

Some signs and symptoms may differ by the organ that was transplanted.

Liver

  • Yellowing of the skin and eyes (jaundice)
  • Dark urine
  • Itchy skin
  • Belly pain

Pancreas

  • High blood sugar
  • Belly pain
  • Vomiting

Kidney

  • Urinating less often
  • Sudden weight gain (2 to 4 pounds in 24 hours)
  • Swelling in ankles

Heart

  • A fast or irregular heartbeat
  • Dizziness or fainting
  • Urinating less often
  • Feeling like it’s hard to breathe
  • Sudden weight gain or swelling

Lung

  • Feeling like it’s hard to breathe
  • A cough

What should you do if you have symptoms?

If you notice any new symptoms, let your doctor know right away. Symptoms of organ rejection may look or feel like a different type of illness. So it's important for your doctor to do tests so that you can get the right treatment as soon as possible.

How is it diagnosed?

Organ rejection can be diagnosed with blood tests. These tests may show the problem before symptoms start.

The doctor also may do a biopsy. This is a test on a small sample of tissue taken from the organ. In some cases, the doctor may use imaging tests, such as an MRI, an ultrasound, or a CT scan.

How is it treated?

Organ rejection is treated with medicines that weaken your body's immune response. The treatment may depend on any other conditions you have. It may also depend on how much time has passed since the transplant.

Medicines that reduce your body's immune response can make it hard to fight infections. So you may also get medicines to prevent infections.

You may be treated in the hospital or at home. If you have other conditions, you're more likely to stay in the hospital. Whether in the hospital or at home, you will be watched closely to be sure your medicines are working.

How can it be prevented?

You can take steps to keep your new organ healthy and help you live longer.

  • Get the recommended follow-up care.
    • Go to your doctor appointments.
    • Get regular blood and tissue tests.
  • Take your antirejection medicines as directed.
    • Know the side effects of these medicines so that you’re ready for them.
    • Know what to do if you miss a dose.
    • Consider talking to someone who has had a transplant about how to make these medicines part of your daily life.
  • Talk to your doctor if anything changes. For example, talk to your doctor if:
    • You have any new symptoms.
    • You’re missing doses of your antirejection medicines.
    • You have severe side effects from the medicines.
    • You are thinking about taking any over-the-counter medicines. These include cold or herbal remedies. Other medicines may interact poorly with your antirejection medicines.