Chronic Transplant Rejection

Chronic Transplant Rejection is a long-term complication that can occur after an organ transplant. It affects the transplanted organ, such as the kidney, heart, or lung, by causing gradual damage over time. This damage results from the body's immune system slowly attacking the transplanted tissue, leading to scarring and loss of function. Patients may experience a slow decline in how well the organ works, which can affect overall health and quality of life. The process is different from immediate rejection because it happens over months to years and is harder to reverse. Monitoring for signs of organ dysfunction is important to detect this condition early.

Chronic Transplant Rejection is characterized by progressive loss of graft function due to immune-mediated injury involving both cellular and humoral immune responses. The core pathology includes vascular intimal thickening, interstitial fibrosis, and parenchymal atrophy within the transplanted organ. It is primarily caused by a persistent alloimmune response against donor antigens, often involving antibody-mediated injury and chronic inflammation. This leads to narrowing of graft blood vessels and ischemic injury, resulting in gradual organ failure. It is a major cause of late graft loss and differs from acute rejection by its insidious onset and resistance to standard immunosuppressive therapies. Histopathology typically shows fibrointimal hyperplasia and mononuclear cell infiltration.