It’s been 2 weeks after the transplantation. On my side, the pain from the operation is subsiding. However Grandma didn’t have such a smooth sailing process. She faced hyper acute renal transplantation rejection straight after the transplantation.



Kuby, Janis (1992). Immunology. Transplantation Immunology (pp. 492). USA: Freeman



Kuby, Janis (1992). Immunology. Transplantation Immunology (pp. 494). USA: Freeman


Dr Leevur explained that it is due to activation of T cells (white blood cells), which, in turn, stimulate specific antibodies against the graft. Various clinical syndromes of rejection can be correlated with the length of time after transplantation. He said that the transplant needed to remove immediately so as to prevent a severe systemic inflammatory response.

His words left us feeling as we were back to square one. ):

My interest on the rejection grew as I really wanted to know what’s going on in Grandma’s body. He went on to show me diagrams summarising the four different types of rejections:

1) Hyperacute rejection – occurs immediately in the operation room
2) Acute rejection- occurs both 10days after transplantation
3) Late acute rejection- occurs approximately 6 months after transplantation
4) Chronic rejection- occurs more than 1 year after transplantation

Dr Leevur said that Grandma was suffering from Hyperacute rejection. It could be avoided if tissue typing and ABO blood group typing are performed prior to transplantation. These pre-existing antibodies can be detected and graft that will result in hyperacute rejection can be avoided. He added that due to time constraint, he did not perform this typing for us. Thus, the transplant must be immediately removed. The doctor recommended Grandma undergoes a artificial kidney transplant.

To make things worse, Dr Leevur said that artificial kidney transplant is not a very established treatment. He warned us of the many complications and hopes we will consider over the weekends.

This is totally a snowball effect; problem is just getting bigger and bigger.

Sigh

Kuby, Janis (1992). Immunology. Transplantation Immunology (pp. 489). USA: Freeman

I found this diagram to help better understand about what happens to the blood vessel on acceptance and rejection. Click on the picture to get a clearer picture!