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Transplant Rejection of Kidney

Last updated Jan. 6, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Transplant Rejection of Kidney occurs when the immune system of the recipient recognizes the new kidney as being a foreign object and thus, harmful.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Kidney Graft Rejection
  • Organ Rejection - Kidney
  • Renal Graft Rejection

What is Transplant Rejection of Kidney? (Definition/Background Information)

  • Kidney transplantation is a procedure to surgically remove a damaged or diseased kidney and replace it with a healthy kidney, from a compatible donor
  • Transplant Rejection of Kidney occurs when the immune system of the recipient recognizes the new kidney as being a foreign object and thus, harmful.
  • Every individual has an immune system that ensures that no foreign particle or material enters the body. Sometimes, when there is an entry of a foreign substance, the body automatically starts to react or fight against the substance, in order to eliminate it from the body
  • The immune cells attack the foreign object, in this case, a donor kidney, in an attempt to destroy it, if they do not recognize the antigens of the new kidney
  • Antigens are foreign entities that get introduced in the body, against which antibodies are produced to render them harmless. Hence the need for matching the ‘donor’ to the ‘recipient’ as immunologically close as possible, by using tissue-typing techniques
  • The types of Transplant Rejection of Kidney are as follow:
    • Acute: An immune response is observed in the first few months after the transplant. This is common, since the body needs to get used to the addition of the new organ before beginning to accept it
    • Chronic: It takes several years to resolve and may damage the transplanted organ
    • Hyperacute: Completely mismatched kidney transplantation could result in very severe immune reactions, which could be fatal
  • An infection, being exposed to individuals with illnesses, certain medications, etc. might predispose an individual to a severe or more prolonged Transplant Rejection of Kidney
  • An adverse reaction to a new kidney could occur if the recipient and donor are ‘mismatched’; if the recipient suffers from some chronic disease or disorder; or, is on certain medications that could trigger such a response
  • The characteristic symptoms of such a rejection could include fever, inability to urinate, aches, breathing difficulties, and discomfort. Individuals who have received a new kidney are generally placed under close observation
  • Any rejection may be diagnosed by doing functional tests on the new organ, tests to check other vital organs, imaging studies to assess damage, if any, etc. Medications are usually prescribed to address any Kidney Transplant Rejection. If diagnosed and treated promptly, and if the affected individual responds satisfactorily, the prognosis can be good

Who gets Transplant Rejection of Kidney? (Age and Sex Distribution)

  • Any individual who receives a kidney transplant can potentially reject it
  • This condition is observed in both males and females
  • Generally, individuals with weaker immune systems have a lower risk of graft rejection than those with stronger immunity

What are the Risk Factors for Transplant Rejection of Kidney? (Predisposing Factors)

Some of the predisposing factors that could potentially lead to Transplant Rejection of Kidney include:

  • Infection
  • Age: Younger the age, higher the risk
  • Prior similar episodes
  • Medications
  • Being around individuals who are ill
  • Noncompliance with therapy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Transplant Rejection of Kidney? (Etiology)

The causes for Transplant Rejection of Kidney could include

  • The donor organ being “mismatched” or not matching closely with the recipient’s body system
  • An adverse reaction that occurs when the body recognizes the new organ as being harmful
  • Underlying conditions such as an infection or a chronic illness

What are the Signs and Symptoms of Transplant Rejection of Kidney?

The signs and symptoms of Transplant Rejection of Kidney include:

  • Increase in body temperature
  • Difficulty breathing
  • Flu-like symptoms
  • Noticeable change in body weight
  • Inability to urinate
  • Inflammation, in or around the transplanted kidney
  • Upset stomach
  • Aches and discomfort
  • Abnormal heart rhythm

How is Transplant Rejection of Kidney Diagnosed?

A diagnosis of Transplant Rejection of Kidney may be made through the following measures:

  • A physical examination after completion of the transplant
  • Keeping the patient under observation to check for any sign of rejection
  • Assessment of kidney function
  • Imaging studies, such as ultrasound of the kidney and chest x-ray
  • Echocardiograph to check heart function
  • Biopsy of the kidney tissue: A piece of tissue is taken and sent to the laboratory for examination by a pathologist under the microscope. The pathologist will look for possible microscopic changes that could be present in the rejected kidney

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Transplant Rejection of Kidney?

The possible complications associated with Transplant Rejection of Kidney include:

  • Obstruction in the kidney 
  • Excessive loss of blood
  • Aneurysm
  • Low blood pressure
  • Complete blockage of the urine flow passage (transplanted organ failure)
  • Swelling
  • Lymphocele
  • Hydrocele
  • Infection

How is Transplant Rejection of Kidney Treated?

Transplant Rejection of Kidney is usually treated with:

  • Medications to stop the adverse reaction
  • Immunosuppressants, to allow the body to accept the new organ
  • Hospitalization in severe cases, till the condition resolves

How can Transplant Rejection of Kidney be Prevented?

Transplant Rejection of Kidney could potentially be prevented by:

  • Tissue-typing of the recipient and donor to get as close a match as possible, so that adverse reactions could be minimized
  • Regular post-surgery follow-up
  • By identifying the issue in its early stages, so that it could be treated effectively

How is the Prognosis of Transplant Rejection of Kidney? (Outcomes/Resolutions)

  • The prognosis of Transplant Rejection of Kidney is considered satisfactory, if the complications are diagnosed and treated promptly
  • If the condition is not addressed on time, the complications could get very severe, necessitating dialysis
  • In some rare cases, an extreme Transplant Rejection of Kidney is a possibility, which can be fatal

Additional and Relevant Useful Information for Transplant Rejection of Kidney:

  • A kidney transplant procedure should only be performed if it is deemed absolutely necessary, as the surgery itself can lead to severe obstruction, if not performed properly, apart from the possibility of a transplant rejection
  • Kidney transplantation procedures are required for patients with long-term kidney failure/end-stage kidney disease, when the kidneys are unable to remove waste material from the body

The following article link will help you understand kidney transplant surgical procedure:


What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 23, 2015
Last updated: Jan. 6, 2019