Kidney Transplant Program - Rejection

What is rejection?

Rejection is the immune system's normal and expected reaction to foreign matter in the body, including the transplanted kidney.  Although your risk for rejection decreases over time, it never goes away.  The risk is always there, which is why you must follow your medical treatment plan closely.  Approximately 90% of rejection episodes are successfully treated.

What can I do to help prevent rejection?

The following suggestions offer some things you can do to keep your new kidney healthy and lessen your chances of rejection.  However, remember that your physician and the transplant team are your best sources of information for your particular medical treatment plan.

Take your medications exactly as prescribed.  Many medications must be taken at the same time each day. Never discontinue a medication or change the dosage unless instructed to do so by the transplant team or your physician.

Visits to your local lab are scheduled at regular intervals.  Your transplant team uses the results of these tests to monitor the levels of medications in your blood, as well as to check for infections, signs of rejection and other medical conditions. 

Maintain proper nutrition to stay healthy.  Regular exercise is important to maintaining good health.

Stop smoking.  Smoking constricts your blood vessels and can have damaging effects on your transplanted kidney. Smoking is also associated with cancers. 

Avoid drinking alcohol, including beer, wine, even some cough suppressants.  Many medications can have adverse reactions with alcohol.

Illicit drugs, including marijuana, are never acceptable for transplant recipients.

What can I do to prevent infections?

• Wash you hands, especially before eating anything.
• Keep your hands away from your face and mouth.
• Avoid people who have colds or infections.
• Ask visitors that are ill not to visit.
• Brush your teeth twice daily and visit your dentist twice each year.
• Avoid handling animal waste.

What are some of the signs of rejection?

Memorize the signs of rejection and monitor yourself for them every day:

• fever - prolonged nausea, vomiting, or diarrhea
• cough - inability to take medications (due to vomiting, for example)
• lightheadedness - vaginal discharge or itching
• shortness of breath - pain or a burning feeling upon urination
• blood in urine - tenderness, redness, or swelling at the incision site
• skin rash - decrease in urine output
• strong odor to the urine - fluid retention or weight gain of 2 lbs in 24 hours

What should I do if I notice any of the signs of rejection?

Immediately call your local VA renal physician or transplant nurse coordinator for instructions.  Your local VAMC team may consult with the Portland VA transplant team.  Your symptoms will be evaluated and an appropriate treatment  plan will be determined.

What happens if my new kidney fails?

Even if you follow every suggestion listed above, rejection is still a possibility.  Most transplant recipients will experience some kind of rejection, but that does not mean that they will lose their new kidney.  If you do lose your new kidney, you will have to return to dialysis.  At that point you may be asked to consider if you would like to undergo another kidney transplant, provided the transplant team has given their approval.