Plain-language explanations of why the immune system can attack a transplanted organ, how the different types of rejection are classified and treated, and how anti-rejection medicines work. Written for transplant recipients, families and students.
An overview of the immune processes behind transplant rejection
Direct and indirect allorecognition by recipient T cells leads to tubulitis, interstitial inflammation and endothelialitis. Graded with the Banff classification. Learn more
Donor-specific antibodies (DSA) bind endothelial HLA, activating complement (C4d deposition) and causing microvascular inflammation. Learn more
Pre-formed antibodies cause graft loss within minutes to hours. Now rare because of crossmatch testing before transplant. Learn more
Maintenance therapy commonly combines a calcineurin inhibitor, an antimetabolite and a steroid; induction agents are used around the time of transplant. Learn more
Blood tests, drug levels and biopsy remain central; newer markers such as donor-derived cell-free DNA are being used to support non-invasive monitoring. Learn more
Chronic antibody-mediated injury is a major cause of late graft loss; transplant glomerulopathy and interstitial fibrosis are key biopsy findings. Learn more
How acute rejection is triggered, what warning signs to report, and how it is diagnosed.
Read ArticleAn overview of current immunosuppressive drugs and newer approaches transplant patients may hear about.
Read ArticleMechanisms, diagnosis and treatment of antibody-mediated rejection, a leading cause of late graft loss.
Read ArticleReference pages and practical resources
How cellular and antibody-mediated rejection are usually treated.
Plain-language definitions of HLA, DSA, Banff, trough levels and more.
Links to official transplant organizations and patient support groups.
A private medication log and a transplant journey timeline.