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The most common symptoms of kidney transplant rejection include flu-like symptoms, decreased output of urine, overnight weight gain, pain in the transplant area, and fatigue. A mild episode of rejection may not be evidenced outwardly with clinical symptoms. Rejection refers to the body's protective immune response to the transplanted kidney. Transplant rejection usually does not result in permanent damage to the transplanted organ. It is treated by adjusting the dosage of immunosuppressant medications.
Organ rejection is the body's natural response to the presence of a foreign object, in which the immune system attempts to defend against the transplanted organ. Medications such as tacrolimus (Prograf®) or cyclosporine A (Sandimmune®) are used to proactively guard against kidney rejection after a transplant, but kidney transplant rejection can still occur in 10 to 20 percent of patients. Rejection does not necessarily indicate the imminent failure or loss of the transplanted organ. The likelihood of kidney transplant rejection is greatest during the first six months after the transplant, and rejection becomes less likely with the passage of time.
Kidney transplant rejection is often a mild and asymptomatic condition and is detected only by subtle changes in bloodwork. If outward symptoms of rejection do occur, they can include a variety of signs. The patient could experience symptoms similar to the flu, including dizziness, aches, headache, chills, or nausea and vomiting. He or she might run a fever of at least 100 degrees F (38 degrees C) or experience tenderness in the kidney area. Other potential symptoms include fluid retention and swelling, fatigue, significant decrease in output of urine, and abrupt weight gain of five or more pounds in a 24-hour period.
Rejection of a transplanted kidney could be sudden or gradual. Both types of rejection are generally indicated in bloodwork by a rise in levels of creatinine. Other means of diagnosing kidney transplant rejection include a renal flow scan, which is used to check the blood flow to the new kidney, and a surgical biopsy of a small piece of the kidney. A rejection episode is treated by brief hospitalization to provide intravenous immunosuppressive drugs, perform repeated laboratory tests to evaluate bloodwork, and assess the patient's progress with adjustments to medication.
Kidney transplants are generally recommended for individuals with end-stage renal disease who will be able to tolerate major surgery. The kidney is the organ most frequently transplanted in the United States, with more than 12,000 kidney transplants performed annually. The transplant donor and the organ recipient can both live with one functioning kidney.