Virginia Commonwealth University

VCU Massey Cancer Center

Organ rejection

What is rejection?

Rejection is a normal reaction of the body to a foreign object. When a new liver is placed in a person’s body, the body sees the transplanted organ as a threat and tries to attack it. The immune system makes antibodies to try to kill the new organ, not realizing that the transplanted liver is beneficial. To allow the organ to successfully live in a new body, medications must be given to trick the immune system into accepting the transplant and not thinking it is a foreign object.

What is done to prevent rejection?

Medications must be given for the rest of the individual’s life to fight rejection. Each person is individual, and each transplant team has preferences for different medications. The following anti-rejection medications are among the most commonly used:

  • Cyclosporine
  • Tacrolimus 
  • Prednisone

The doses of these medications may change frequently, depending upon your response. Because anti-rejection medications affect the immune system, individuals who receive a transplant will be at higher risk for infections. A balance must be maintained between preventing rejection and making you very susceptible to infection. Blood tests to measure the amount of medication in the body are done periodically to make sure you do not get too much or too little of the medications. White blood cells also are an important indicator of how much medication you may need.

This risk of infection is especially great in the first few months because higher doses of anti-rejection medications are given during this time. You will most likely need to take medications to prevent other infections from occurring. Some of the infections you will be especially susceptible to include oral yeast infection (thrush), herpes and respiratory viruses.

What are the signs of rejection?

The following are the most common symptoms of rejection. However, each individual may experience symptoms differently:

  • Fever greater than 100°F.
  • Jaundice – yellowing of the skin and eyes. 
  • Dark urine. 
  • Itching. 
  • Abdominal swelling or tenderness. 
  • Fatigue. 
  • Irritability. 
  • Headache.

The symptoms of rejection may resemble other medical conditions or problems. Consult your transplant team with any concerns you have.