Rejection reactions

A distinction is made between acute and chronic rejection as possible consequences of transplantation to be avoided.

The greatest risk of acute rejection is present during the first six months. However, it is a lifelong possibility. There is an increased risk with infections, especially with diarrhoeal disease because the immunosuppressants can lose their effect. However, most acute rejections can today be treated successfully.

Chronic rejection is also called graft-vessel disease.  This consists of increasing sclerosis of the small blood vessels. However, graft-vessel disease appears to occur more seldom in children’s hearts. A possible explanation is that the donor organs for children are simply younger and less stressed than those from adult donors, an advantage that might also be effective in heart-lung transplantation in childhood.