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Weird Medical Question - Regarding Organ Transplants


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#1 sierraleone

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Posted 31 January 2020 - 09:07 PM

I was pondering the other day, how when organ transplants fail the recipient dies, cuz the organ was necessary for life. Then I wonder, what happens if it was not a necessary organ? I expect there'd still be complications, but would it always be lethal complications sans anti-rejection meds unless perfect match?

So, lets assume medical ethics have been ignored. A person has only one kidney, but it is a *good* *healthy* kidney. But a donor kidney gets put in them anyways, and they are not treated for this.

I know the immune system will respond, but is it necessary fatal? I figure the poor speculative possibilities I could come up with ranged from:

1) Rare long term result: stable due to calcification (like lithopedions from abdominal pregnancies)

2) Likely: the immune system goes on red-alert all over the place, & something like analyphatic shock kills the donee.

3) Possible: the immune system focuses on the donor kidney & maybe adjacent tissue,
but it is on yellow-orange alert all over the body leading the immune system to over-react to other problems, & cause issues similar to allergies &/or autoimmune diseases. So issues could be sporadic, & the risk of a life-threatening immune response is increased & could happen at any time.

4) Possible: the immune system hyper focuses on the donor kidney & maybe adjacent tissue,
but that interferes with blood flow & the donor kidney ends up dying, with all the complication of rotting internal tissues inherent with that, with infections the immune system is unequipped for, like gangrene & sepsis, resulting in death.

5) Unlikely: the immune system hyper focuses on the donor kidney & maybe adjacent tissue,
so complications are minimal, tho immune system may not be able to divide it's attention well if other infections come up, leading to opportunities infections that the immune system would normally be able to fight off.
Rules for surviving an Autocracy:

Rule#1: Believe the Autocrat.
Rule#2: Do not be taken in by small signs of normality.
Rule#3: Institutions will not save you.
Rule#4: Be outraged.
Rule#5: Don't make compromises.
Rule#6: Remember the future.
- Masha Gessen
Source: http://www2.nybooks....r-survival.html

#2 Orpheus

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Posted 02 February 2020 - 08:01 PM

I'm nowhere near a transplant specialist, but here goes:

GROSSLY oversymplified, there are several classes of rejection

a) Hyperacute -- a severe systemic immune reaction in the first few days after a transplant. When this occurs, it is usually important to remove the transplant immediately, if practical. Failure to do so is very often fatal in a matter of days.

b) Acute -- generally begins 5-100 days after the transplant, and results more in damage to the target (transplanted) organ than to the host's overall body. Every transplant experiences some degree of acute rejection. It can range from mild redness in a connective tissue transplant to severe organ shutdown. Acute rejection is managed by anti-rejection drugs; exacerbations are generally treated by increasing the dose.

c) Chronic -- can begin from months to years after the transplant. It is generally low progressive damage tothe target organ, again treated by long-tern use of anti-rejection drugs

d) Graft vs Host disease -- I'm not sure this is really classified as a rejection, but it's similar. It can occur after blood transfusions, bone marrow transplants, stem cell transplants and some solid organ transplants. This is a complex field, but basically the graft begins to attack the host or uses the host's own immune system against some antigen in the host's own tissues (which the graft sees as foreign).

e) Others -- but now we're getting into rare stuff I barely recall and am not remotely competent to discuss.

That's as much as I'd dare say without a lot of review (this is not something I've ever dealt with much), but if you have specific questions, I can look up the answers.

So for a transplanted kidney in a person who still has one healthy kidney #1 is unlikely. The kidney is a highly vascular organ and plays countless roles in stabilizing the whole body's physiology. It would not be left in long enough to calcify. The risk of patient death would be too high. There is something called nephrocalcinosis (mostly calcification of kidney blood vessels) and of course, calcifications in the ducts, renal pelvis, ureters, etc are one type of kidney stone (the renal pelvis is a kind of funnel that the renal tubules empty into; it's unrelated to "the pelvis" of common English), but these and other "renal calcifications" are very different from what you are describing.

Broadly speaking, #2, #3, #4, #5 and/or situations "close enough" to them,  are quite possible and hardly rare. The patient's treatment team would be on the lookout for them.

#3 sierraleone

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Posted 03 February 2020 - 05:16 PM

Thanks Orpheus, I thought that you might have something to add. :duhsmile:
Rules for surviving an Autocracy:

Rule#1: Believe the Autocrat.
Rule#2: Do not be taken in by small signs of normality.
Rule#3: Institutions will not save you.
Rule#4: Be outraged.
Rule#5: Don't make compromises.
Rule#6: Remember the future.
- Masha Gessen
Source: http://www2.nybooks....r-survival.html


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