Dr. Goran Klintmalm
Baylor, Health

Mediaplanet: Are there long-term health risks transplant patients need to be aware of?

Dr. Goran Klintmalm: As with any organ transplant, it is highly likely that the individual will go on to enjoy a normal and productive life with a much improved health and quality. The long-term success of the surgery, though, depends in large part to the patient’s adherence to a lifelong regime of immunosuppressant (anti-rejection) medicines.

When an organ is newly transplanted into a recipient, the body’s natural reaction is to reject it by producing special cells and antibodies that attack and compromise its function. Immunosuppressant drugs allow the transplanted organ to remain healthy and free from damage or attack, and maintain normal function. Decades of research and historical observation tell us that patients who are vigilant in taking immunosuppressants minimize the risk of rejection, and are the most likely to have a long life with the transplanted organ.

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The goal in selecting a combination of medicines for each patient is to prevent organ rejection with the fewest number of side effects. There are a few notable reactions that can occur when taking any medication that suppress the body’s natural immunity; hence prior to surgery patients are educated about the inherent risks of the medication compared to the benefits of life-saving transplantation surgery.

The regime of immunosuppressants is life-long and requires careful monitoring of the medication along with the organ’s function. We consider individuals who have had an organ transplant to be a patient for life, since we work together to maintain the organ, treat any other health issues, as well as adjusting medication dosages as needed. 

The experience of large transplant programs in the United States is extensive, thereby reducing surgical risks. We now know that the highest likelihood that a patient may lose the organ actually occurs after surgery, depending whether he/she adheres to medication schedules. Not following dosage changes, missing medications, or even failing to take the immunosuppressants can jeopardize not only the organ, but the patient’s life.

Michelle Altrich, Ph.D., HCLS (ABB)
Vice President and Clinical Laboratory Director, Viracor-IBT Laboratories

Mediaplanet: Why are screening tests and diagnostics useful throughout the transplant process? 

Michelle Altrich: Managing successful transplantations is a balancing act of preventing infections and minimizing the opportunity for organ rejection. Screening, diagnostic testing and the lab’s ability to provide fast results, play critical roles throughout the transplant process. Before the transplant occurs, screening tests are performed to see if infectious diseases are present in the donor, to determine the general acceptability of the organ and tissue to suitable recipients. This can include everything from common diseases such as Hepatitis and HIV, to rare diseases found in specific geographical regions.

Additionally, genetic compatibility or HLA tests can be performed pre-transplant to assess if the donor and recipient are a good match. Matching the donor antigens in the recipient may improve chances for long-term graft survival, lower rejection rates and reduce incidents of infection. After the transplant, complications can very quickly cascade into a life-threatening situation. Symptoms often mimic each other, making diagnosis and management complex.

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Specialized diagnostics with fast result turnaround time allows physicians to monitor for immune system related complications so they can diagnose and differentiate when it matters most, and provide successful intervention to prevent rejection or infection. Specialized laboratories and tests are available to help physicians better manage transplant patients. It’s important to talk with your physician about the availability and role of testing in your treatment plan.