Medical disclaimer: Educational information only, not medical advice. AcuteRejection.com is not a medical provider and does not diagnose or treat any condition. Always consult your transplant team or another qualified healthcare professional, and never change or stop anti-rejection medication on your own. If you think you have an emergency, call your local emergency number.
34 terms, listed alphabetically.
- Allograft
- An organ or tissue transplanted between two genetically different people of the same species.
- Allorecognition
- The process by which the recipient's immune system recognizes donor tissue as foreign, either directly (donor cells present their own HLA molecules) or indirectly (recipient cells present processed donor HLA).
- Anti-thymocyte globulin (ATG)
- An antibody preparation that depletes T cells; used for induction and for treating more severe or steroid-resistant cellular rejection.
- Antibody-mediated rejection (AMR)
- Rejection driven by antibodies, usually donor-specific antibodies against HLA, that injure the small blood vessels of the graft.
- Banff classification
- An international system pathologists use to grade rejection and other findings on transplant biopsies.
- Belatacept
- An intravenous drug that blocks a co-stimulation signal T cells need to activate; used in some kidney recipients instead of a calcineurin inhibitor.
- Biopsy
- Removal of a small sample of the transplanted organ for examination under a microscope; the standard way to confirm rejection.
- BK virus
- A common virus that can reactivate under immunosuppression and damage a transplanted kidney; it can mimic rejection on biopsy.
- C4d
- A complement fragment that can be detected in biopsy tissue; its deposition in capillaries is one marker of antibody-mediated injury.
- Calcineurin inhibitor (CNI)
- A class of immunosuppressants (tacrolimus, cyclosporine) that block T-cell activation by inhibiting the enzyme calcineurin.
- Chronic rejection
- Slow, ongoing immune injury that leads to scarring and gradual loss of graft function over months to years.
- Creatinine
- A blood waste product used to estimate kidney function; a rise in a kidney recipient can be an early sign of rejection or other problems.
- Crossmatch
- A pre-transplant test checking whether the recipient has antibodies that react against the donor's cells.
- Cytomegalovirus (CMV)
- A common virus that can cause serious infection after transplant; many recipients receive preventive antiviral medicine.
- Desensitization
- Treatments used before transplant to lower antibody levels in highly sensitized recipients.
- Donor-derived cell-free DNA (dd-cfDNA)
- Fragments of donor DNA in the recipient's blood; higher levels can indicate injury to the graft, including rejection.
- Donor-specific antibody (DSA)
- An antibody in the recipient that targets the donor's HLA (or other) antigens.
- eGFR
- Estimated glomerular filtration rate, a calculation of kidney function based mainly on blood creatinine.
- Graft
- The transplanted organ or tissue.
- HLA (human leukocyte antigen)
- Proteins on cell surfaces that the immune system uses to distinguish self from non-self; the main target in transplant rejection.
- Hyperacute rejection
- Very rapid rejection, within minutes to hours, caused by pre-existing antibodies; now rare because of crossmatch testing.
- Induction therapy
- Strong immunosuppression given around the time of transplant to lower early rejection risk.
- IVIG (intravenous immunoglobulin)
- Pooled antibodies from donors, used in desensitization and in treating antibody-mediated rejection.
- Maintenance immunosuppression
- The long-term combination of anti-rejection medicines taken after transplant, commonly a calcineurin inhibitor, an antimetabolite and a steroid.
- mTOR inhibitor
- A class of immunosuppressants (sirolimus, everolimus) that block a cell-growth signalling pathway in lymphocytes.
- Mycophenolate (MMF / MPA)
- An antimetabolite immunosuppressant that blocks lymphocyte proliferation by inhibiting purine synthesis.
- Panel reactive antibody (PRA / cPRA)
- A measure of how sensitized a candidate is, expressed as the percentage of potential donors they would have antibodies against.
- Plasmapheresis (plasma exchange)
- A procedure that removes antibodies from the blood; used for antibody-mediated rejection and desensitization.
- PTLD
- Post-transplant lymphoproliferative disorder, a lymphoma-like condition linked to immunosuppression and Epstein-Barr virus.
- Rituximab
- An antibody that depletes B cells; sometimes used in desensitization or antibody-mediated rejection.
- T-cell-mediated rejection (TCMR)
- Rejection in which T lymphocytes infiltrate and injure the graft; also called acute cellular rejection.
- Tacrolimus
- The most widely used calcineurin inhibitor; blood levels are monitored to balance rejection risk against side effects.
- Trough level
- The drug concentration in the blood just before the next dose, used to monitor drugs such as tacrolimus.
- Tubulitis
- Inflammation of kidney tubules by lymphocytes seen on biopsy; a key feature of T-cell-mediated rejection in kidney grafts.