Kidney Transplant Rejection and Infection: The Changes That Mean Calling Your Team Today

The phone call usually comes on an ordinary afternoon. Someone who felt fine at breakfast is told that the bloodwork from their routine clinic visit looks different: the creatinine has drifted up, and the team wants a repeat sample tomorrow. Nothing hurts. Nothing has visibly changed. And yet the sentence that follows, “we want to rule out rejection,” lands like a dropped glass.

That gap between how a person feels and what the lab shows is the single most important thing to understand about kidney transplant rejection signs. The most reliable warning is often a number, not a sensation. The second most important thing is that infection, the other great worry after transplant, can produce almost the same picture, and the treatment for one can worsen the other.

This explainer walks through what rejection actually is, how it shows up, how it is told apart from infection, and which changes mean picking up the phone today.

Why kidney transplant rejection signs are quieter than most people expect

A healthy kidney has enormous reserve. It can lose a meaningful share of its filtering capacity before anyone feels tired, swollen or unwell, which is exactly why kidney disease in the general population is so often found by accident on a blood test. A transplanted kidney behaves the same way. Early rejection chips away at function silently, and the body does not sound an alarm until the damage is well under way.

This is the reason transplant programs insist on such frequent monitoring in the first months. MedlinePlus describes the standard follow-up pattern: blood tests to measure creatinine and immunosuppressant levels, urine checks for protein and blood, and clinic visits that are weekly at first and spread out as the kidney settles. Creatinine, a waste product cleared by the kidney, rises when filtering drops, so a creep above your personal baseline is often the first and only clue.

Symptoms, when they come, tend to be nonspecific. Fever, aching, feeling “off,” passing less urine, puffiness around the ankles: none of these points uniquely at rejection. People sometimes wait to see whether the feeling passes, reasoning that a cold or a long day could explain it. After a transplant, that ordinary reasoning carries risk, because the window in which rejection is most reversible is also the window in which it is least dramatic.

The practical upshot is a small change in how you relate to your own body. Rather than asking “do I feel sick enough to call?”, the question becomes “has anything changed from my usual?” Transplant teams would far rather hear about a false alarm than meet a kidney that has quietly been under attack for a fortnight.

What actually happens during rejection: how the immune system reads a new kidney

Your immune system identifies cells by protein markers on their surface called human leukocyte antigens, or HLA. Think of them as a molecular ID badge. Donor and recipient are matched as closely as possible, but unless the donor is an identical twin, some badges differ. White blood cells called T cells read those differences and, left alone, would treat the kidney as a large invader.

Immunosuppressant medicines exist to blunt that response. Most people after kidney transplant take a combination from a few drug classes, each acting at a different step. Calcineurin inhibitors interrupt the chemical signal T cells need to activate. Antiproliferative agents slow the multiplication of immune cells. Corticosteroids dampen inflammation broadly. The Mayo Clinic and NIDDK both note that these medicines are typically taken for as long as the kidney functions, and that the regimen is adjusted over time by the transplant team based on blood levels, kidney function and side effects. Those adjustments always belong to the prescribing clinician.

Rejection happens when the balance tips. Sometimes blood levels of a medicine fall, perhaps because of missed doses, vomiting, or an interaction with another drug or with grapefruit. Sometimes the immune system mounts a stronger response than the regimen was designed to hold. Two main patterns result. In T-cell-mediated rejection, immune cells infiltrate the kidney tissue directly. In antibody-mediated rejection, the body manufactures antibodies against donor HLA, known as donor-specific antibodies, which damage the small blood vessels inside the graft.

Both patterns cause inflammation and reduced filtering, and both can coexist. Which one is present matters, because the treatments differ, and that is why a biopsy, a tiny tissue sample examined under a microscope, is so often needed before any decision is made.

What are the stages of transplant rejection?

Clinicians sort rejection by timing and mechanism, and the vocabulary is worth learning because you will hear it in clinic.

Hyperacute rejection is the rarest and the fastest. It occurs within minutes to hours of the kidney being connected, driven by antibodies the recipient already carried before surgery. MedlinePlus notes that it is now uncommon because pre-transplant crossmatch testing, which mixes donor cells with recipient blood in the lab, is designed to detect exactly those antibodies. When it does occur, the kidney usually has to be removed.

Acute rejection is the type most people mean when they say “rejection.” According to MedlinePlus it can occur at any time but is most likely in the first weeks to months after the operation, when the immune system is still encountering the new tissue and medicine levels are being fine-tuned. The NHS describes it as a common complication and emphasizes that episodes are frequently treatable when caught early, which is the reason for intensive early monitoring. Acute rejection is further labeled as cellular (T-cell driven) or antibody-mediated, and a biopsy grading system scores how severe the inflammation is.

Chronic rejection is a slower process unfolding over months to years. Rather than an acute flare, it involves progressive scarring and narrowing of the kidney’s small vessels, often with low-grade antibody activity. It tends to show up as gradual creatinine rise, increasing protein in the urine, and rising blood pressure. Current medicines are far better at preventing and treating acute rejection than at reversing chronic damage, which is why so much long-term care focuses on prevention.

A fourth term, borderline rejection, describes biopsy changes that are suspicious but do not meet the full threshold. Teams weigh these findings alongside your labs and history rather than treating them automatically.

What does kidney rejection feel like?

Honest answer: for many people, like nothing at all, at least at first. When sensations do arrive, they cluster into a few recognizable groups.

The first group is systemic. A low-grade fever, chills, body aches and a flu-like heaviness are common. People often describe it as “coming down with something” that never quite develops into a proper cold. Appetite can fade. Fatigue feels different from ordinary tiredness; rest does not seem to fix it.

The second group relates to the kidney itself. The transplanted kidney sits low in the abdomen, usually on one side just above the groin, which makes it easier to feel than native kidneys. Rejection can make it tender, swollen or firm. Some people notice a dull ache or pressure at the incision site weeks or months after it healed.

The third group reflects falling kidney function. Urine output may drop noticeably. Fluid that would normally be filtered out accumulates instead, producing swollen ankles, puffy hands or face, and a rapid weight gain of a few pounds over a day or two. Blood pressure often climbs. Urine can look darker, cloudy or foamy, and occasionally pink or red.

None of these is diagnostic on its own. Cleveland Clinic and Mayo Clinic both list essentially this same cluster and pair it with the same instruction: contact the transplant team rather than interpret it yourself. The team’s job is to put the sensation beside your creatinine, your drug levels, your urine studies and, if needed, a biopsy, and to read the whole picture.

One pattern deserves special mention. A person who has recently been vomiting, had diarrhea, or simply forgotten several doses, and then develops any of these changes, should mention the missed medicine first. It changes how quickly the team acts.

Signs of infection after kidney transplant, and why they look like rejection

Immunosuppression is a trade. The medicines that protect the kidney also lower defenses against bacteria, viruses and fungi, and the NHS lists infection as one of the most frequent complications in the first year. The uncomfortable twist is that infection and rejection share a symptom list: fever, fatigue, aching, reduced urine, and a rising creatinine.

Why would infection raise creatinine? Several ways. A urinary tract infection, the most common bacterial infection after kidney transplant, can inflame the graft directly. Dehydration from vomiting or diarrhea reduces blood flow to the kidney. Some viral infections, particularly a common virus called cytomegalovirus (CMV) and a kidney-dwelling virus called BK virus, can injure the transplanted tissue themselves. BK virus is a particular concern because it causes a type of kidney damage that mimics rejection under the microscope and is treated by reducing immunosuppression, the exact opposite of rejection treatment.

Certain features lean toward infection. Burning or urgency with urination, cloudy or foul-smelling urine, and pain in the bladder area suggest a urinary infection. Cough, shortness of breath or chest discomfort point to the lungs. Sores in the mouth, difficulty swallowing, persistent diarrhea or a new rash suggest viral or fungal causes. Shaking chills with a high fever favor a bacterial bloodstream infection, which needs urgent evaluation.

The timing also helps. Johns Hopkins and Mayo Clinic describe the early months, when immunosuppression is heaviest, as the period of greatest vulnerability to opportunistic infections, the ones a healthy immune system would ordinarily keep in check. Many programs prescribe preventive antimicrobials during this phase for that reason. Later, the more typical community infections dominate, though they can still hit harder.

Because the treatments pull in opposite directions, nobody should try to self-sort these two possibilities at home. The team will.

Rejection or infection? A side-by-side look at what differs

The table below is not a self-diagnosis tool. It shows why clinicians need tests, and it may help you give a clearer account when you call.

Feature	More typical of rejection	More typical of infection	Common to both
Fever	Often low-grade or absent	Can be high, with chills or sweats	Any fever needs reporting
Urinary symptoms	Less urine, foamy or darker urine	Burning, urgency, cloudy or smelly urine	Blood in urine
Local findings	Tender, swollen or firm graft	Bladder or flank discomfort, cough, mouth sores, rash	Abdominal discomfort
Blood tests	Rising creatinine, possibly new donor-specific antibodies	Raised white cell count or inflammatory markers; viral tests positive	Creatinine can rise in either
Key history	Missed doses, low drug levels, recent reduction in immunosuppression	Exposure to sick contacts, recent dehydration, new cough or diarrhea	Recent travel or hospital stay
Direction of treatment	Immunosuppression typically increased or changed	Infection treated; immunosuppression sometimes reduced	Decided only after testing

Notice how much overlaps. A person with BK virus can have a tender graft and a rising creatinine with no fever. A person with cellular rejection can run a fever and feel exactly like they have influenza. The table’s real message sits in the last row: the two conditions call for opposite moves, and the only safe way to choose is to test.

When you call, the most useful details are your temperature, how your urine output compares to usual, any weight change, whether you have missed or vomited any medicine, and any new cough, diarrhea or burning on urination. Keeping a simple daily log of weight, temperature and blood pressure, as many programs ask, turns a vague feeling into a measurable trend.

Who is watched most closely, and who is usually asked to wait

Rejection risk is not evenly spread. Teams follow some people more intensively, and the reasons are useful to know.

Higher immunologic risk comes from having more pre-formed antibodies against HLA, often the result of previous transplants, blood transfusions or pregnancies. People with a greater number of HLA mismatches with their donor, and those who received a kidney from a deceased rather than living donor, are also commonly monitored more closely in the early period. Younger recipients tend to have more vigorous immune systems and are often followed closely for that reason. People whose medicine blood levels have been difficult to stabilize, or who have had a prior rejection episode, sit in the same category.

Monitoring also tightens whenever immunosuppression is deliberately lowered, for example to treat BK virus, a serious infection, or a cancer. During those phases the team accepts a higher rejection risk in exchange for controlling the other problem and compensates with more frequent labs.

“Asked to wait” applies to a different set of decisions. Transplant programs commonly advise postponing certain things until the kidney is stable and immunosuppression has been reduced to a maintenance level, because the early months carry the highest risk of both rejection and infection. Live vaccines are generally avoided altogether on immunosuppression, while inactivated vaccines are typically timed by the team. Travel to areas with limited medical access, dental procedures, and elective surgery are often deferred. Pregnancy is usually discussed as something to plan with the team once function has been stable for a period they define, since some immunosuppressants are not safe in pregnancy and must be switched well beforehand.

None of these are rules you can look up and apply yourself. They are starting points for a conversation with the team that knows your labs, your antibodies and your history.

How transplant teams confirm rejection: labs, antibodies and biopsy

Suspicion starts with trend. A single creatinine value means little; what the team watches is movement away from your own baseline, which is why they ask for repeat samples rather than acting on one result. Alongside creatinine they check the blood level of your calcineurin inhibitor, because a low level is a common and correctable explanation. Urine is tested for protein and blood and cultured for infection.

If those first steps do not explain the change, an ultrasound of the graft is often next. It shows whether urine is draining properly, whether the kidney is swollen, and whether blood flow through its vessels is normal. A blocked ureter or a fluid collection pressing on the kidney can mimic rejection and is treated completely differently.

Blood is also sent for donor-specific antibodies, the antibodies directed at the donor’s HLA markers. A new or rising antibody raises concern for antibody-mediated rejection. Some programs additionally use newer blood tests that detect fragments of donor DNA released by injured graft cells, though these are used alongside, not instead of, the standard workup.

The definitive step remains the biopsy. Under local anesthetic and ultrasound guidance, a needle removes a sliver of kidney tissue, which a pathologist examines for inflammation in the tubules, vessels and the tiny filters called glomeruli. Special stains look for antibody deposits and for BK virus. The pathologist assigns a grade using an internationally standardized classification, and that grade, together with the clinical picture, guides treatment.

Biopsy carries a small risk of bleeding, which is why you will be observed afterward and asked to avoid heavy lifting for a short period. Most people describe the procedure as uncomfortable rather than painful. The alternative, treating blind, means risking the wrong direction of therapy, which is why teams rarely skip it.

What the days and weeks after a rejection diagnosis usually look like

Being told you have rejection is frightening, and it helps to know the shape of what follows. The NHS and MedlinePlus both stress that most episodes of acute rejection detected early can be treated, and that treatment commonly means intensifying immunosuppression rather than losing the kidney.

For cellular rejection, the usual first step is a short course of high-strength intravenous corticosteroid given over several days, sometimes as an inpatient, sometimes in a day unit. Steroids suppress the activated T cells and reduce inflammation quickly. If the biopsy shows more severe inflammation, or if steroids do not produce the expected improvement, the team may add an antibody-based medicine that depletes or blocks T cells. These are given by infusion and require monitoring for fever and reactions during administration.

Antibody-mediated rejection is handled differently. Treatment aims at the antibodies themselves and the cells that produce them. Options include plasma exchange, a procedure that filters antibodies out of the blood, intravenous immunoglobulin, which interferes with antibody activity, and medicines that target antibody-producing B cells. These are typically delivered as a series of sessions over one to several weeks.

Whatever the regimen, the follow-up intensifies. Expect labs every few days at first, then weekly, with the team looking for creatinine to fall back toward your baseline. Some people have a repeat biopsy to confirm the inflammation has settled. Maintenance immunosuppression is often adjusted upward afterward, and because heavier suppression means higher infection risk, preventive antimicrobials may be restarted for a period.

Recovery of function varies. Some kidneys return fully to their previous level; others settle at a new, slightly higher creatinine. Your team will tell you honestly which pattern they are seeing, and they will not promise an outcome, because the biology does not allow it.

Can your body reject a kidney years later?

Yes. The immune system does not develop permanent tolerance to a transplanted organ with time; it is held in check by medicine for as long as the kidney functions. MedlinePlus is explicit that chronic rejection can develop over many years, and late acute rejection, though less common than early episodes, also occurs.

Late acute rejection has a recognizable set of triggers. The most frequent is reduced medicine exposure. Years into a transplant, when the kidney has been stable and life feels normal, it becomes easier to miss doses, to run out before a refill, or to let clinic visits slip. Some people are tempted to lower their own medicines because of side effects. Interactions matter too: a new antibiotic, antifungal, anti-seizure medicine or herbal product can raise or lower calcineurin inhibitor levels dramatically. Severe illness with vomiting can do the same. Each of these can let the immune system off the leash.

Chronic rejection is subtler. It rarely produces a dramatic episode. Instead, creatinine drifts upward over months, protein appears in the urine, and blood pressure becomes harder to control. On biopsy, the small arteries show thickening, the filters show scarring, and there may be evidence of ongoing low-grade antibody activity. Progression is often slow, and the team’s goals shift toward protecting the remaining function: tight blood pressure control, treating protein loss, managing cholesterol and blood sugar, and keeping immunosuppression steady.

What this means in practice is that the habits of the first year are the habits of every year. Routine labs continue for life, usually spaced out to every few months once stable, because they remain the earliest detector of trouble. A kidney that has worked faithfully for a decade still deserves the same attention it received in its first month.

How to avoid transplant rejection: what the evidence actually supports

No one can promise that rejection will not happen; even perfectly managed transplants sometimes develop it. What the evidence supports is a short list of behaviors that reduce the odds and catch problems early.

Taking immunosuppressants exactly as prescribed is the foundation, and the most-cited reason for preventable rejection is non-adherence. The NIDDK and Mayo Clinic both describe these medicines as daily, lifelong, and sensitive to timing because blood levels need to stay within a target range. Practical tools help: alarms, a weekly pill organizer, keeping a small supply where you spend your days, and a plan for what to do if you vomit a dose. That plan should come from your team, not from a general article.

Telling the team about every new medicine, supplement or herbal product before starting it matters more than most people realize. Interactions are a leading cause of drug levels swinging out of range. Grapefruit and some related citrus affect calcineurin inhibitor levels and are commonly restricted; ask your team what applies to you.

Attending every scheduled blood test is the second pillar. Labs are the early warning system, and skipping them removes it. The same goes for home monitoring of weight, blood pressure and temperature if your program requests it.

Infection prevention protects the kidney indirectly, since infections can trigger rejection and may force reductions in immunosuppression. Hand hygiene, food safety, avoiding sick contacts when possible, and staying current with the vaccines your team recommends all count.

Managing blood pressure, blood sugar and cholesterol protects graft vessels over the long run and is strongly supported by evidence from chronic kidney disease care generally. Smoking cessation belongs on the same list.

Beyond these, be skeptical. Supplements marketed to “support” transplant health have no evidence base and some carry interaction risks.

What people often get wrong about kidney transplant rejection signs

Several beliefs circulate widely enough to be worth correcting directly.

“If I feel fine, the kidney is fine.” The most consequential myth. Early rejection is frequently symptom-free, which is the entire rationale for scheduled labs. Feeling well is reassuring but not conclusive.

“Rejection means I am losing the kidney.” In the early, acute form, rejection is a treatable complication, and the NHS describes it as common and often reversible with prompt treatment. It is a reason to act quickly, not a verdict.

“Once I am a few years out, I am past the danger period.” Risk declines after the first year but never reaches zero. Late rejection, especially linked to missed medicine or drug interactions, is well documented, and chronic rejection by definition happens over years.

“A low-grade fever is not worth a call.” After transplant, any fever is worth a call. Immunosuppression can mute the body’s fever response, so a modest temperature may reflect a more significant problem than it would in someone with a normal immune system.

“Pain at the kidney always means rejection.” Tenderness can also indicate infection, a fluid collection, a blocked ureter or a muscle strain near the incision. It needs assessment, not assumption.

“If my creatinine is a little up, I should drink more water and recheck next week.” Dehydration can raise creatinine, but so can rejection, and the team needs to make that call. Call first.

“Rejection treatment is a one-time fix.” A treated episode often leads to a permanently adjusted regimen and more frequent monitoring, and it does raise the chance of future episodes. It is a chapter, not a closed book.

“I can skip a dose now and then without consequences.” Blood levels of these medicines fall quickly, and even brief gaps can allow immune activation. Consistency is the whole point.

Questions to ask your care team

A transplant clinic visit moves quickly, and good questions change what you get out of it. These are the ones that tend to matter most, grouped by what they clarify.

About your baseline and thresholds: What is my current creatinine, and what rise would prompt you to act? What temperature should I call about? How much weight gain over how many days should worry me? Which blood pressure readings do you want to hear about?

About your medicines: What are my target drug levels, and where am I now? What should I do if I vomit within an hour of a dose, or realize I missed one? Which common over-the-counter medicines, antibiotics and supplements interact with my regimen? Is grapefruit restricted for me?

About monitoring: How often will I need labs this year, and how will that change? Do you want me tracking weight, temperature and blood pressure at home, and how should I share the numbers? Which results will you call me about, and which should I check myself?

About infection: Which vaccines are recommended for me and when? Am I on preventive antimicrobials, and for how long? What symptoms would you want to hear about even without fever?

About the longer view: Do I have donor-specific antibodies, and does that change my plan? What is my risk profile for rejection compared with a typical recipient? When would you consider it reasonable for me to travel, have dental work, or plan a pregnancy?

About contact: Who do I call during the day, after hours and on weekends? Should I go to an emergency department or call the transplant line first? Who is my contact if I am admitted somewhere else?

Bring a written list and write down the answers. Recall after a worrying appointment is unreliable for everyone.

When to call your doctor: red-flag signs that mean today, not tomorrow

The short version: after a kidney transplant, the threshold for contacting your team is lower than it would be for anyone else, and the number to call is the transplant unit, not a general helpline. Most programs run an on-call service for exactly this reason. When in doubt, call.

Call the same day, and do not wait for your next appointment, if you notice any of the following:

• A temperature of 100.4°F (38°C) or higher, or the threshold your team gave you, with or without chills.
• Passing noticeably less urine than usual, or none, over several hours.
• Swelling of the ankles, legs, hands or face, or a weight gain of several pounds over a day or two.
• Pain, tenderness, swelling or firmness over the transplanted kidney.
• Blood in the urine, or urine that is cloudy, foul-smelling, or accompanied by burning or urgency.
• Flu-like aching, unusual fatigue or feeling generally unwell that does not fit a clear explanation.
• Blood pressure persistently above the range your team set.
• Vomiting or diarrhea that prevents you from keeping medicines down, or any missed doses of immunosuppressants.
• A new cough, shortness of breath, mouth sores, severe headache, confusion or a new rash.

Seek emergency care immediately, and tell the staff you are a transplant recipient, if you have severe or sudden abdominal pain, a high fever with shaking chills, difficulty breathing, chest pain, fainting, or you cannot pass urine at all. Infections that would be mild in others can progress quickly in someone on immunosuppression.

A simple rule covers almost every situation: anything new and unexplained is worth a phone call, and the people answering would rather be called for a false alarm than learn later that a kidney was in trouble for days. Every decision about testing and treatment rests with your transplant team; your part is to make sure they know in time.

Frequently asked questions

What are the first kidney transplant rejection signs?

The first sign is usually a rising creatinine on a routine blood test, with no symptoms at all. When symptoms appear, the most common are low-grade fever, flu-like aching, tiredness, passing less urine, swelling of the ankles or face, rapid weight gain, and tenderness or swelling over the transplanted kidney. Blood pressure may also climb. Any of these should be reported to the transplant team the same day rather than monitored at home.

What does organ rejection feel like?

Many people feel nothing in the early stages. Those who do often describe it as coming down with a flu that never fully arrives: achiness, chills, unusual fatigue and a loss of appetite. Some notice a dull ache, pressure or firmness over the kidney, which sits low in the abdomen. Others mainly notice fluid changes such as puffy ankles, less urine and a few pounds of sudden weight gain. None of these feelings is specific to rejection.

Can your body reject a transplant years later?

Yes. The immune system never develops lasting tolerance to the kidney; it is held in check by medicine for as long as the graft functions. Late acute rejection is most often linked to missed doses, running out of medicine or drug interactions that lower immunosuppressant levels. Chronic rejection, a slow scarring process, by definition develops over years and shows up as gradual creatinine rise, protein in the urine and harder-to-control blood pressure.

What are the different stages of transplant rejection?

Clinicians describe three main types by timing. Hyperacute rejection occurs within minutes to hours of surgery and is now rare because of pre-transplant crossmatch testing. Acute rejection can happen at any time but is most common in the first weeks to months and is further classified as T-cell-mediated or antibody-mediated. Chronic rejection develops over months to years through progressive scarring. Biopsy grading adds a severity score within each category.

How to avoid transplant rejection?

The strongest evidence supports taking immunosuppressants exactly as prescribed every day, attending every scheduled blood test, and telling your team before starting any new medicine, supplement or herbal product because interactions can shift drug levels. Preventing infection, controlling blood pressure, blood sugar and cholesterol, and not smoking protect the kidney over the long term. No approach eliminates risk entirely, which is why monitoring continues for life.

What are the signs of infection after kidney transplant?

Fever and chills are the most important, and immunosuppression can blunt them, so even a modest temperature matters. Burning or urgency with urination, cloudy or foul-smelling urine, cough or shortness of breath, mouth sores, persistent diarrhea, and new rashes each point toward infection. Because infection can also raise creatinine and cause fatigue and aching, it often looks like rejection, and the transplant team needs to test to tell them apart.

How is kidney transplant rejection diagnosed?

The team starts with trends in creatinine, immunosuppressant blood levels and urine tests, then often orders an ultrasound to check drainage and blood flow and a blood test for donor-specific antibodies. The definitive test is a kidney biopsy, in which a small tissue sample taken under local anesthetic is examined for inflammation, antibody deposits and BK virus. The biopsy grade and clinical picture together guide treatment.

Does rejection mean I will lose my kidney?

Not usually, when it is acute and caught early. Both the NHS and MedlinePlus describe acute rejection as a common complication that is often treatable by intensifying or changing immunosuppression. Some kidneys recover fully; others settle at a slightly higher creatinine. Chronic rejection is harder to reverse, and care then focuses on protecting remaining function. Your team cannot promise a specific outcome, but a rejection diagnosis is a call to act, not a verdict.

How is kidney transplant rejection treated?

Treatment depends on the biopsy. T-cell-mediated rejection is typically treated first with a short course of intravenous corticosteroid, with antibody-based medicines that deplete T cells added if needed. Antibody-mediated rejection is treated with approaches that remove or neutralize antibodies, such as plasma exchange and intravenous immunoglobulin, sometimes with medicines targeting antibody-producing cells. Maintenance immunosuppression is usually adjusted afterward, and monitoring becomes more frequent. All choices rest with the transplant team.

When should I go to the emergency room after a kidney transplant?

Go immediately, and tell staff you are a transplant recipient, if you have a high fever with shaking chills, severe or sudden abdominal pain, difficulty breathing, chest pain, fainting, confusion, or you cannot pass urine at all. For less dramatic changes such as a low-grade fever, reduced urine, swelling or graft tenderness, call the transplant unit the same day; most programs run an on-call line and prefer early contact.

References

• MedlinePlus: Transplant rejection
• NHS: Kidney transplant, Risks
• NIH NIDDK: Kidney Transplant

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.