Article Sections

Introduction

A wide range of complications can occur hours to years after solid organ transplantation.  They can impair allograft function (eg, acute rejection) or systemic recipient health (eg, opportunistic infections).  Solid organ transplant complications can be classified as ( Table 1):

  • Immunologic
  • Infectious
  • Noninfectious

This article details these 3 types of complications, then presents a timeline-based differential diagnosis for clinical practice.  Kidney, heart, and lung transplants are used as examples, but the principles also apply to other solid organ (eg, liver, pancreas) transplants.

Immunologic complications

Solid organ graft rejection is classified as hyperacute, acute, or chronic ( Table 2).

Hyperacute rejection (minutes to hours after transplant)
  • Preformed recipient antibodies immediately attack antigens expressed on the graft vascular endothelium (eg, human leukocyte antigens [HLA], ABO antigens).  Prior recipient sensitization (eg, previous blood transfusions, multiparity) is the main risk factor.  Upon antibody attack, massive complement activation results in

Continue Learning with UWorld

Get the full Solid Organ Transplant: Complications article plus rich visuals, real-world cases, and in-depth insights from medical experts, all available through the UWorld Medical Library.

Figures

Figure 1
Figure 1
Figure 2
Figure 2

Images

Image 1
Image 1
Image 2
Image 2

Tables

Table 1
Table 2