Treatment for heart transplant rejection

Rejection is a normal reaction of the body to new tissue put in or on the body. When a person gets a heart transplant, the body’s immune system reacts. Immune cells can attack the new heart. Medicine can help to prevent this. But in many cases, rejection can still happen.

Types of treatment

Treatment depends on:

• The severity of the rejection

• Your symptoms

• Your current medicines

• The type of rejection

Some treatment choices include:

• Taking more of the anti-rejection medicine

• Taking the anti-rejection medicine more often

• Changing to a different anti-rejection medicine

• Taking other medicines to suppress the immune system, such as prednisone

For severe cases, medicines may need to be given through a vein (IV).

Other treatments include:

• Plasmapheresis. This treatment may be used for antibody-mediated rejection. It filters the blood and removes harmful antibodies.

• Photophoresis. This treatment uses ultraviolet (UV) light. It impairs immune cells, so they don't attack the new heart.

• Lymphoid irradiation. This treatment uses radiation to damage the lymph nodes that make an immune response.

• Medicines for heart failure. These include beta-blockers. This type of medicine may be needed if the rejection is harming your new heart.

After you get treatment for rejection, you will need to be closely watched. You may need follow-up tests to see how the treatment is working.

While taking anti-rejection medicine

Medicines that help to prevent rejection suppress the body’s immune system. This will raise your risk for infection. You may need to take antibiotic and antiviral medicines. These are needed if you are taking certain anti-rejection medicines. They don’t treat the rejection itself. But they help prevent infection.

Possible complications of heart transplant rejection

In rare cases, heart transplant rejection can cause problems such as:

• Heart failure

• Abnormal heart rhythms, some of which can cause sudden death

• Heart attack

Preventing problems

Here are ways you can help reduce your risk of rejection and problems related to it:

• Take all your medicines as directed.

• Make sure not to run out of medicine.

• Check your weight, blood pressure, and temperature as you are told by your healthcare provider.

• Make sure to go to all your healthcare appointments.

• Get your blood tests and other tests done on time.

• Follow up on your tests with your transplant team.

• Live a heart-healthy lifestyle with physical activity and healthy foods.

• Don’t use tobacco products.

• Don’t drink too much alcohol.

• Call your transplant team right away if you have symptoms of rejection.

Living with a heart transplant

Your healthcare provider may give you more advice about how to manage your transplant. This includes:

• Living a healthy lifestyle. Eat heart-healthy foods and get enough exercise. Stay away from tobacco products, illegal drugs, and excess alcohol. Keep a healthy weight.

• Taking other medicines for your heart. These might include medicines to reduce cholesterol, lower your blood pressure, or help manage your blood glucose. Some of these medicines may help lower the chances of chronic rejection.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Feeling tired or weak

• Fever or chills

• Shortness of breath

• Fast or irregular heartbeat

• Drop in blood pressure

• Swelling of your feet, hands, or ankles

• Sudden weight gain

• Flulike aches and pains

• Reduced amounts of urine

• Dizziness or fainting

• Nausea or loss of appetite