From the Guidelines
Three recipient-specific risk factors for acute cellular rejection include younger recipient age, history of prior sensitization, and poor medication adherence, as these factors can significantly impact the immune system's response to the transplanted organ. When considering the risk of acute cellular rejection, it is essential to evaluate the recipient's overall health and medical history. Younger recipients typically have more robust immune systems that can mount stronger responses against the transplanted organ. Prior sensitization occurs when a recipient has been exposed to foreign antigens through previous transplants, blood transfusions, or pregnancies, creating memory T cells that can rapidly recognize and attack the new organ 1. Poor medication adherence to immunosuppressive regimens directly impacts the body's ability to tolerate the transplanted organ. Some key points to consider when assessing the risk of acute cellular rejection include:
- The recipient's age and immune system function
- History of prior sensitization or exposure to foreign antigens
- Adherence to immunosuppressive medication regimens
- Regular blood level testing of immunosuppressants, especially in the first year post-transplant when rejection risk is highest, as mentioned in the context of managing liver transplant patients 1. Additional factors that may increase rejection risk include certain HLA mismatches between donor and recipient, underlying autoimmune conditions, and infections that can trigger immune system activation. Early recognition of these risk factors allows for personalized immunosuppression protocols and more vigilant monitoring to prevent rejection episodes.
From the Research
Recipient Specific Risk Factors of Acute Cellular Rejection
- The presence of anti-human leukocyte antigens antibodies is a risk factor for acute cellular rejection 2
- Cystic fibrosis recipients have a higher risk of acute cellular rejection due to enhanced immune activation related to the genetic disorder and younger age 3
- A history of non-adherence to immunosuppressive therapy is a risk factor for acute cellular rejection, as it can lead to an increased immune response against the transplanted organ 4