Rejection of transplant heart, liver, or kidney.
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The body’s response to the transplanted organ is called rejection. Very often, your body’s immune system may try to tear off the liver during the first month after transplantation, usually within the first 7-10 days.
In most patients, at least one episode of mild or moderate rejection occurs during this time. This is a normal reaction for the immune system and a transplanted liver, which indicates that your immune system is working. However, in order to protect the transplanted liver and maintain its function at a good level, your immune system must be very selectively and metered in order to prevent rejection from occurring. For this, immunosuppressants are used for life in various combinations and decreasing doses over time.
Rejection can be called “acute”, which means its rapid development, when the immune system tries to destroy liver cells. If rejection develops slowly over time, this is called chronic rejection. Treatment for chronic rejection may be more complicated than acute treatment due to prolonged changes in liver tissue. Acute rejection can occur even against the background of careful and regular intake of drugs, but most likely it will occur if you miss several doses in a row. Chronic rejection develops most often as a result of albeit short, but frequent omissions of prescribed immunosuppressants. In the vast majority of cases, with timely detection and treatment, rejection is completely reversible.
How do you know if a transplanted liver is rejected?
Damage to the liver can cause the release of normal liver proteins, or enzymes, into the bloodstream. Damage can be caused by rejection, infection, toxic effects of drugs and other liver diseases. Regular measurement of these enzymes, i.e. blood tests, as well as monitoring the nature of changes in their results, it is necessary to notice the problem in time and solve it.
Liver rejection is usually diagnosed based on a comprehensive assessment of the tests. Your doctor may suspect you have developed rejection if any of these values increase compared to normal. Clinical signs and examination data, ultrasound examination (ultrasound), etc. are also taken into account.
What are the symptoms of rejection?
While you are in the hospital, transplant center doctors monitor your tests (including those that reflect liver function) daily. If during this time you develop liver rejection, you may not feel any signs, since rejection was detected early on the basis of blood tests.
After you leave the hospital, blood tests and instrumental examinations will be performed less frequently, but regularly. With the development of rejection, you may develop some mild symptoms, although most often the state of health does not change, at least for some time.
The most common early signs of rejection include the following:
_ Increased liver enzymes;
_ Pain or soreness in the right hypochondrium;
_ Flu-like symptoms, in particular, chills, nausea, vomiting, diarrhea, headache, dizziness, soreness in the body, fatigue;
_ Fever / high temperature 37.5 ° C.
Symptoms that occur later may resemble those that you had before the transplant, and may include the following:
_ Yellowing of the skin and eyes (jaundice);
_ Dark color of urine (tea color);
_ Light color of feces (clay color);
_ Increased fatigue;
Should you always worry about rejection of a transplanted liver?
The risk of rejection decreases over time, but it can occur at any time. Attentiveness to yourself, taking the drugs as prescribed, performing blood tests as required, as well as regular visits to the doctor of your transplant center will help reduce the risk of rejection. The key factors for a successful transplant outcome are regular communication with the Center’s doctor who observes you, in which the transplant was performed, as well as the recommendations for taking medications and lifestyle. Currently, rejection is being successfully treated, thanks to the development of immunosuppression and the emergence of groups of drugs aimed at preventing rejection.
Your responsibilities for monitoring yourself and reducing your risk of rejection:
_ Take all drugs strictly as prescribed.
_ Always have a supply of drugs with you.
_ Regularly come to receptions and examination in order to track any changes in the state of immunity and liver function.
_ Donate for testing as recommended.
_ Observe the results of blood tests in conjunction with a transplant doctor.
_ Know and understand the symptoms and complaints that are characteristic of liver problems.
_ Tell your doctor if you have any symptoms that do not go away on their own.
_ Avoid drinking alcohol, unknown drugs, herbal supplements.
It is important to remember that under the conditions of modern highly effective immunosuppressive therapy, the course of rejection can be asymptomatic and manifest itself only in the laboratory: an increase in ALT, AST, and bilirubin in the blood. Therefore, it is so important not to deviate from the schedule of tests prescribed by the doctor.