Kidney Transplant Rejection

Kidney Transplant Rejection


Rejection is most common in the first 6 months after transplant surgery, but it can happen at any time. Treatment is most effective if rejection is caught early.

Your immune system is made up of white blood cells and antibodies. Together, they work to get rid of germs and disease that may be harmful to the body. The newly transplanted organ is viewed by the immune system as a foreign object that is harmful to the body. Your immune system will try to get rid of it, and this is known as rejection.

Anti-rejection medicines must be taken every day, as ordered, to prevent rejection. These medicines weaken the immune system, but they allow the body to accept the transplanted organ.

Warning signs of rejection

Learn these signs of rejection while in the hospital, so you can be aware of them when you go home. Call your Transplant Coordinator right away if you see any of these signs:

  • A fever over 100.5 degrees F or 38 degrees Celsius.
  • Sudden weight gain of 2 pounds in 1 day, or 5 pounds or more in 1 week.
  • Swelling in the face, abdomen, arms, hands, legs or feet.
  • Not feeling well or constant fatigue.
  • Decreased urine output, either going less often or passing less urine.
  • High blood pressure - top number, called systolic pressure, 160 or higher, or your pressures are trending higher than your usual readings
  • Elevated creatinine or BUN lab values. 

If the transplant team thinks you may be having rejection, testing is done to check if rejection is happening in your kidney. Tests may include:

  • More blood work to check your creatinine or BUN values.
  • Ultrasound.
  • Kidney biopsy.


Treatment for rejection

To reduce your chance of rejection, take your medicines as ordered every day, and do not skip doses. Have your blood tests taken as scheduled, and attend all follow up visits.

Rejection is part of transplantation. Although every precaution is taken to prevent it, rejection can still happen. If your kidney shows signs of rejection, there are several treatment options:

  • Dose or amounts of your anti-rejection medicine may be changed.
  • Anti-rejection medicines may be changed.
  • If a biopsy shows rejection, you may be hospitalized for more intensive care or treatment.


© 2006 - August 29, 2019, The Ohio State University Wexner Medical Center.

This handout is for informational purposes only. Talk with your doctor or healthcare team if you have any questions about your care. For more health information call the Library for Health Information at 614-293-3707 or email: