Rejection of Transplanted Kidney
The immune system is the body's defense to protect it against things that don't naturally belong to it. These things can include:
- Viruses
- Bacteria
- "Foreign" tissue from someone else like your child's transplanted kidney
After transplant, the Pediatric Kidney Transplant team at Cincinnati Children's Hospital Medical Center will prescribe special immunosuppressant or "anti-rejection" medications for your child to take. Without these drugs to modify or "trick" the immune system, it would recognize the transplant as being foreign and produce antibodies to attack or "reject" the kidney.
The most important thing that you can do to prevent a rejection episode from occurring is to ensure your child takes his / her medications every day as directed. Sometimes, though, a rejection episode can occur even though your child has done everything correctly.
During a Rejection Episode
During a rejection episode the transplant kidney may not function as well as it should. This does not necessarily mean, though, that it will stop working completely or that your child will lose the new kidney. When recognized and treated early, it is possible to stop the rejection with little or no damage to the kidney.
In addition to taking medications as directed, it is very important that you keep all of your child's follow-up clinic appointments so that the transplant team can detect any signs of rejection by changes in your child's physical exam or in kidney function lab tests.
Although rejection can occur without any symptoms at all, you should notify the transplant team immediately if any of the following warning signs occur:
- Fever over 100 degrees. Fever is usually a sign that the immune system is trying to fight off something. While your child can still get a fever with colds and other types of infections, it can also be a sign of rejection.
- Other flu-like symptoms, such as chills, headache, body aches, fatigue or dizziness
- Pain or tenderness over the site of the transplanted kidney
- Sudden weight gain or swelling of hands, feet, legs or eyelids
- Difficulty breathing
- Pain or burning during urination or a noticeable decrease in the amount of urine
Kidney Biopsy
In most cases where rejection is suspected, a kidney biopsy is necessary to confirm the diagnosis.
A needle is painlessly guided through the abdominal wall and into the kidney to remove a tiny piece of kidney tissue. By looking at the tissue under the microscope, the doctors can tell if rejection is the source of the problem.
If a biopsy is done, your child will need to stay in the hospital to rest in bed for about 23 hours afterwards. If a rejection episode is confirmed, it will be treated with a strong anti-rejection medication (usually given through some type of IV) for 3-10 days, depending on which medication is given. Sometimes this may require a few additional days in the hospital.
After the rejection has been treated, the doctor may change one or more of your child's immunosuppressant medications in order to help prevent future rejection episodes from occurring. As discussed earlier, the best way for you to minimize your child's risk for rejection is to ensure that your child:
- Takes all of his / her medications each day as directed
- Follows the transplant team's instructions for follow-up visits and lab work
- Leads a healthy lifestyle
Rev. 1/07
