Transplant rejection occurs when the body’s immune system attacks foreign material, such as a transplanted organ. Anti-rejection drugs are used to reduce the immune response, but weaken the patient’s immune system, making them more vulnerable to infections. The goal of transplant specialists is to reduce rejection and create drugs without life-threatening complications.
Graft rejection is caused by the body’s immune response to foreign material. The body naturally tends to try to destroy the foreign bodies it encounters. As a result, those receiving the transplants are given transplant rejection drugs that reduce the body’s immune response.
In most cases, white blood cells, called leukocytes, serve our body very well. They identify viruses and bacteria that have entered our bloodstream and begin to assiduously eliminate them. White blood cells help us recover from diseases and also prevent us from contracting some diseases because we have already become immune to them from the previous action of white blood cells.
However, when someone receives a transplant, the white blood cells work against the new organ. They immediately recognize the organ as foreign and set about destroying it. More leukocytes are produced to clear the body of the organ, creating a battle between the new organ and the white blood cells.
When the white blood cells are effective, this causes transplant rejection. Transplanted organs are usually tested for the presence of white blood cells to assess the amount of rejection. The answer to this problem is problematic in itself. White blood cells must be reduced in order for the new organ to do its job.
Therefore, those receiving an organ take immunosuppressant drugs that can prevent transplant rejection. This results in a weakened immune system, because leukocytes are not available to fight the normal diseases one might encounter. Those who receive a transplant are therefore more vulnerable to both viruses and infections. In addition to medications for transplant rejection, most frequent transplant recipients must take antibiotics or take large doses of prophylactic antibiotics to prevent infections.
Long-term use of antibiotics creates another problem. Germs tend to become resistant to antibiotics over time, so fighting bacteria means switching to newer, stronger antibiotics. Additionally, patients may be allergic to certain classes of antibiotics, limiting the types of medications patients can take. A stronger antibiotic also results in more side effects such as frequent fungal or yeast infections, stomach upset, and skin rashes.
Therefore, trying to avoid graft rejection requires a very delicate pharmaceutical balance. A sufficient number of leukocytes must have been eliminated to avoid rejection of the transplant, but not so many that viruses claim the patient’s life. Antibiotics must be given to stop the infection; however the antibiotics need not be so strong that the patient dies from antibiotic resistant disease.
With anti-rejection drugs, graft rejection is now reduced to about 10-15%. A close match between blood groups and blood factors helps, but the body still “knows” that the organ is not of the body. Only identical twin transplants and corneal transplants appear not to be recognized by leukocytes. Furthermore, heart valves taken from pigs, cows and cadavers appear not to be considered “foreign”. Graft rejection is often not the cause of death in transplant patients. Fighting transplant rejection is. Transplant complications are more likely to cause death than transplant rejection.
The field of transplant technology is, however, constantly evolving. At one time almost all transplants were refused. Now, ongoing research into anti-rejection drugs is turning the tide of transplant rejection and transplant drug complications.
The goal of transplant specialists is to reduce rejection and also to create drugs that do not cause life-threatening complications in transplant recipients. When this milestone is reached, the medical sector will certainly be able to claim victory.
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