i may lose the kidney

Quote from: MooseMom on September 24, 2010, 08:53:43 PM

I'm sorry to be so uninformed, but I didn't realize there were different kinds of rejection. Could someone tell me more about this?

Acute rejection

Acute rejection usually begins one week after transplantation (as opposed to hyperacute rejection, which is immediate). The risk of acute rejection is highest in the first three months after transplantation. However, acute rejection can also occur months to years after transplantation. A single episode of acute rejection is not a cause for concern if recognized and treated promptly, and rarely leads to organ failure. But recurrent episodes are associated with chronic rejection. Acute rejection occurs to some degree in all transplants (except those between identical twins). It is caused by mismatched HLA, which are present on all cells of the body. There are a large number of different alleles of each HLA, so a perfect match between all HLA in the donor tissue and the recipient's body is extremely rare. The diagnosis of acute rejection relies on clinical data, including patient signs and symptoms, laboratory testing and ultimately a tissue biopsy. The biopsy is interpreted by a pathologist who notes changes in the tissue that suggest rejection. Acute transplant rejection can be treated using chemotherapeutic drugs designed to suppress the immune system (see list below). Acute rejection is normally treated initially with a short course of high-dose corticosteroids, which is usually sufficient to treat successfully. If this is not enough, the course can be repeated or a triple therapy regimen can be used, consisting of a corticosteroid plus a calcineurin inhibitor and an anti-proliferative agent.

Chronic rejection

The term "chronic rejection" was initially a term used to describe a long-term loss of function in transplanted organs, associated with fibrosis of the internal blood vessels of the transplanted tissue. But this pathology is now termed chronic allograft vasculopathy. The term chronic rejection is reserved for cases of transplant rejection where the rejection is due to a poorly understood chronic inflammatory and immune response against the transplanted tissue. Chronic transplant rejection is irreversible and cannot be treated effectively. Treatments with inhaled cyclosporin are being investigated as a means to delay or prevent chronic rejection of the lungs. At present the only definitive treatment is re-transplantation, if patients can be re-allocated and if donors are available.