Diagnosis & Testing
What Is Organ Rejection?
Normally, the body’s immune system protects the body from infection. This occurs when cells of the immune system move around the body, checking for anything that looks foreign or different from the body’s own cells.
Rejection occurs when the body’s immune cells recognize the transplanted heart as different from the rest of the body and attempts to destroy it. If left alone, the immune system would damage the cells of a new heart and eventually destroy it.
To avoid rejection, heart transplant recipients must strictly adhere to their immunosuppressant drug regimen. Researchers are continually working on safer, more effective and well-tolerated immunosuppressant drugs. However, too much immunosuppression can lead to serious infections. Without an active enough immune system, a patient can easily develop severe infections. For this reason, medications are also prescribed to fight infections.
The Myocardial Biopsy: Heart transplant recipients are carefully monitored for signs of rejection. Doctors frequently take samples of small pieces of the transplanted heart to inspect under a microscope. Called a biopsy, this procedure involves advancing a thin tube called a catheter through a vein to the heart. At the end of the catheter is a bioptome, a tiny instrument used to snip off a piece of tissue. If the biopsy shows damaged cells, the dose and kind of immunosuppressive drug may be changed. Biopsies of the heart muscle are usually performed weekly for the first three to six weeks after surgery, then every three months for the first year, and then yearly thereafter.
It is vital for you to be aware of the possible signs of rejection and infection so you can report them to your doctors and be treated immediately.
Signs of organ rejection include:
- Fever over 100.4°F (38°C).
- “Flu-like” symptoms such as chills, aches, headaches, dizziness, nausea, and/or vomiting.
- Shortness of breath.
- New chest pain or tenderness.
- Fatigue or generally feeling “lousy.”
- Elevation in blood pressure.
Watching for Infection
With too much immunosuppression, the immune system can become sluggish, and a patient can easily develop severe infections. For this reason, medications are also prescribed to fight infections. It is vital for you to be aware of the possible signs of rejection and infection so you can report them to your health care providers and be treated immediately.
Warning signs of infection include:
- Fever over 100.4°F (38°C).
- Sweats or chills.
- Skin rash.
- Pain, tenderness, redness or swelling.
- Wound or cut that won’t heal.
- Red, warm or draining sore.
- Sore throat, scratchy throat or pain when swallowing.
- Sinus drainage, nasal congestion, headaches or tenderness along upper cheekbones.
- Persistent dry or moist cough that lasts more than two days.
- White patches in your mouth or on your tongue.
- Nausea, vomiting or diarrhea.
- Flu-like symptoms (chills, aches, headache or fatigue) or generally feeling “lousy.”
- Trouble urinating: pain or burning, constant urge or frequent urination.
- Bloody, cloudy or foul-smelling urine.
If you have any of these symptoms of rejection or infection, notify your doctor right away.
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