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Rejection is the refusal of your body to recognize your new lungs as its own, recognition of the transplanted lung as being foreign to the body and the attempt to fight and destroy it. This reaction originates within your immune system which is very potent and recognizes things that don't belong in your body. For example, your body identifies a splinter in your finger as a foreign object. The redness and inflammation in the area of the splinter is an immune response.
When a major organ such as the lung is implanted, your body will recognize it as foreign and will mount an immune response directed at the new lung (rejection). In order to prevent rejection, you must be treated with immunosuppressants, medications that interfere with the body's normal immune response. Taking these drugs must become second nature to you because they require a lifelong commitment.
It is expected that you may have episodes of rejection in the first several months after transplant. These are not uncommon. The treatment requires that you come into the hospital for a few days and receive doses of the anti-rejection medications intravenously. Determining the proper levels of immunosuppressant medication is a matter of frequent adjustments, as each individual is unique and requires and individualized approach. To assist in this adjustment process and to catch any episodes of rejection or infection early, when they are easier to treat, you will be asked to monitor your lung function at home and to report any significant changes. Our goal is to find the lowest dose that will prevent rejection and therefore minimize the risk of infection and side effects from the medications.
Because your immune system is suppressed to prevent you from rejecting your new lung, you are more prone to infection. Because of this, we will monitor your temperature and the white blood cell count of your blood daily, while you are hospitalized. Infections are generally treated with antibiotics, sometimes only for one to two weeks, but possibly longer. In addition, you will be asked to take certain medications on a regular basis to prevent certain types of infection.
Once you have decided to pursue lung transplantation, you must accept responsibility to take the anti-rejection medications as prescribed by the team every day sometimes twice a day, for the rest of your life. Failure to take these medications will result in the rejection of your new lung. Rejection of the lung can result in death. You are also responsible for keeping your appointments with the Lung Transplant Team to ensure that you are receiving the appropriate amount of each medication, that rejection is not occurring, and that you are not developing an infection.
REMEMBER: A lung transplant is not a cure but a treatment for your lung disease.
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Division of Thoracic Surgery
Brigham and Women's Hospital
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Boston, MA 02115