Which of the following symptoms indicate acute rejection of a transplanted kidney?
A. Edema, Nausea
B. Fever, Anorexia
C. Weight gain, pain at graft site
D. Increased WBC count, pain with voiding
Correct Answer: C. Weight gain, pain at graft site
Pain at the graft site and weight gain indicates the transplanted kidney isn’t functioning and possibly is being rejected. In general, when transplanting tissue or cells from a genetically different donor to the graft recipient, the alloantigen of the donor induces an immune response in the recipient against the graft. This response can destroy the graft if not controlled. The whole process is called allograft rejection.
Option A: Transplant clients usually have edema, anorexia, fever, and nausea before transplantation, so those symptoms may not indicate rejection. Allograft rejection is inflammation with specific pathologic changes in the allograft, due to the recipient’s immune system recognizing the non-self antigen in the allograft, with or without dysfunction of the allograft.
Option B: Renal transplant rejection, as stated earlier, is an immunological response that leads to inflammation with specific pathological changes in the allograft, due to the recipient’s immune system recognizing the non-self (foreign) antigen in the allograft.
Option D: Hyperacute rejection is related to preexisting circulating antibodies in the recipient’s blood against the donor antigen (usually ABO blood group or HLA antigen), which is present at the time of transplantation. These antibodies attack and destroy the transplanted organ as soon as or within a few hours after allograft is revascularized.
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