Common complications after organ transplantation

Several risks are directly due to the transplant surgical procedure (mechanical) and/or linked to the donor (quality of the graft, ischemia), whereas other complications are strictly medical problems. It's also useful to distinguish early and late complications depending on when they occur in the post transplant course.

Most complications are common to all organ transplantation. They are related to reactions ensuing recognition of transplantation barriers and to the immunosuppressive drugs used to prevent it.

Rejection of the graft

Rejection of the graft remains the main complication after transplantation of allogeneic tissues. However, different type of rejection occurs depending on the organ transplanted. Hyperacute rejection is an hallmark of kidney transplant complication, whereas acute and chronic rejection may occur after any organ transplantation (kidney, liver, pancreas, lung or heart). Read more...

Some allograft are not rejected when the graft is implanted in sites (cornea, cerebral tissues, cartilages) not accessible for lymphocytes (privileged sites).

Infectious complications

Advances in immunosuppressive treatment protocol have considerably decreased the risk of rejection and improved survival rate. On the other side, immunosuppressive drugs lead to important complications for medium and long term management of transplant. Because immunosuppression diminishes immune defenses, transplanted patient are more susceptible to bacterial, fungal and viral infections , which represent a severe post transplant complication. Read more...

Tumors

During medium and long term follow up, immunosuppressive treatment may also facilitate the development of tumor, particularly of the lymphoid system and skin. Read more...

Side effects

Direct toxicity of immunosuppressive drugs may lead to renal or/and hepatic deficiency. Balance between an efficient immunosuppressive treatment to avoid graft rejection and a non-toxic doses is an optimal goal to reach.

Relapse of the original disease

Relapse of the original disease may also be a important source of graft dysfunction, particularly when the transplantation doesn't cure the primary disease (kidney transplantation for diabetes, ...).

Graft versus host disease (GVHD)

The graft versus host reaction may be regarded as the reverse situation of rejection. Donor lymphocytes transplanted with the graft attack the tissues of the immunosuppressed host. The graft versus host disease is a common complication after hematopoietic stem cell transplantation, in which host is immunosuppressed with a high dose conditioning. GVHD is also seen after liver and small bowel transplantation, in which many donor lymphocytes are transplanted with the graft.