Evolution and treatment after a transplant

Follow-up is essential after a transplant. The anti-rejection treatment will need to be taken for life, and transplant patients must also have a healthy, balanced life style.

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Transplants make it possible to save lives every year, and improve the daily life of patients. Generally speaking, we can state that 80% of grafts are still working, 5 years after the transplant. Transplants are thus a great source of hope for patients with chronic failure of a specific organ, or those with a chronic illness.

Complications may nevertheless appear after a transplant, and regular medical follow-up is essential:

An organ transplant is not a simple operation. Because of the many complications possible after a transplant, regular medical follow-up and a healthy life style are recommended for all transplant patients.

THE RISKS FACING TRANSPLANTED PATIENTS

There are several possible risks:

- After a transplant, the recipient will identify its new organ as a foreign body and will try to fight it: this is the principle of rejection. To counteract the major risk that rejection represents, the doctor prescribes transplant patients with immunosuppressant drugs (anti-rejection drugs). The major constraint associated with the immunosuppressant treatment after a transplant is that it is a treatment that must be taken for the rest of the patient’s life.

- The follow-up treatment after a transplant leads to reduced immune resistance in the transplant patient (immune-suppression) so that he or she can better accept the graft. The weakened immune system can thus lead to secondary infections.

- The second cause of death among transplant patients comes from the possibility that the immunosuppressant treatment provokes cancer. This thus needs careful monitoring. Immunosuppressants effectively weaken the immune defences to prevent the body from rejecting the graft. The direct consequence of this is that the immune system as a whole is weakened, resulting in a heightened risk of viral infection and sensitivity to cancer.

For heart transplant patients, there is a risk of myocardial infarction because the coronary arteries can become blocked.

- Development of graft-versus-host disease. This condition corresponds to an attack by the graft (the donor organ) against the transplanted patient. Graft-versus-host disease can affect the liver, the digestive tract or the skin.

There can also be risks before the transplant, either for the donor or the recipient. These risks can occur when the organ is harvested from the donor, during conservation, or during the transplant procedure.

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