The chief obstacle to living with a transplant is acute rejection. This sort of rejection would happen to nearly all recipients if it weren't for immunosuppressive drugs. As you might expect, immunosuppressive drugs generally suppress elements of the immune system so they do not attack the donor organ. The problem with this is that the drugs also suppress some of the beneficial things the immune system does. A person taking immunosuppressive drugs is much more susceptible to infection and disease.
A new approach may eventually change this course. In a few experimental cases, kidney transplant patients have also received bone marrow transplants from their donors. Bone marrow produces the white blood cells that play a crucial role in guarding the body against foreign matter. The theory behind this new approach is that the white cells from the donor marrow will merge with the recipients's natural cells, allowing the immune system to recognize the new organ as part of the body. The initial experimental results are encouraging. The first test subjects are doing very well without taking any immunosuppressive drugs.
Drugs are still the main course of action, however, and they do yield good results. Typically, a transplant team prescribes specific combinations of drugs to patients in order to achieve the right balance of suppression. The goal is to suppress the system just enough to prevent rejection, while minimizing side effects and the risk of infection. The transplant team usually adjusts the drug prescription over time, fine-tuning it to the patient's needs. In some cases, the patient may eventually be weaned off all drugs as the body adapts to the new organ, but this is extremely rare.
Transplant patients must be vigilant about taking their medication, and they must visit the hospital regularly for follow up tests. But it is worth it in most cases -- patients who have been sick for many years due to a diseased organ may feel completely rejuvenated following a transplant.
Unfortunately, thousands of people never get this chance at a new life. In the next section, we'll find out why this is and look at a few possible solutions.