Glossary of Basic Transplant Terms

Acute Rejection: When the recipient’s immune system recognizes the transplant as a foreign object and tries to attack it.

Antibody: A “Y” shaped immunoglobulin, specialized immune protein, that works with your body’s immune system to fight bacteria and viruses called antigens. The production of antibodies is a major function of the immune system and is carried out by a type of white blood cell called a B cell.

Antigen: A foreigner produced by the body in response to bacteria viruses, blood products or a transplanted organ. The antigen is capable of producing an antibody in response to the foreigner.

Anti-Rejection Medication: Special medication taken by a transplant patient to stop the body from attacking the transplanted organ. These medications are used for prevention and treatment of acute and chronic rejection and are taken forever. Blood work must be monitored to make sure that levels are stable.

Antibody Mediated Rejection (AMR): A form of rejection that can be diagnosed by a biopsy and measuring the antibodies in the blood. AMR has a poor prognosis for graft survival.

Belatacept (Nulojix): An intravenous medication given to prevent or treat rejection. Therapy is given in OIC or hospital.

Biopsy: A sample of tissue or transplanted organ that is analyzed in a lab to diagnose disease or rejection.

Chronic Rejection: A type of rejection that happens slowly by attacking a transplant and eventually causing it to fail.

Cross-match: A blood test is done before the transplant to see if the potential recipient will react to the donor organ. If the cross-match is “positive”, the donor and patient are incompatible because antibodies will immediately react against the donor’s cells and consequently cause immediate loss of the transplant. If the cross-match is “negative”, the transplant may proceed.

Compatible: When there is no reaction between a donor and recipient during the cross-match.

Calculated Panel Reactive Antibody (CPRA): A calculation done by the UNOS computer system that includes PRA and the frequency of the antigen occurring.

Cellcept: An oral anti-rejection medication given pre-transplant to treat autoimmune diseases or to lower high antibodies. Cellcept is also given post-transplant to prevent or treat rejection.

Corticosteroids (Medrol/Prednisone): An oral or intravenous medication to prevent or treat rejection of a transplanted organ. Classified as an anti-rejection medication.

Cyclosporin/Neoral: An oral anti-rejection medication used to treat or protect again rejection of a transplanted organ or tissue.

Deceased: Someone that has died a brain or cardiac death.

Desensitization: A variety of procedures used to decrease the antibody level to allow a transplant to take place. The procedures may include IV medications, plasmapheresis, or a combination of both.

Donor: Someone that gives an organ, tissue or bone. A donor can be living or deceased.

Donor Specific Antibody (DSA): An antibody identified by a blood test that a recipient has a reaction to.

Eculizumab: An intravenous anti-rejection medication that is given to prevent or treat rejection.

End Stage Kidney Disease (ESRD): A form of end organ failure where the kidneys fail to remove waste and fluid from the body. ESRD must be treated by dialysis or transplant. End organ failure, such as heart or liver, is life threatening and can only be treated with a transplant.

Graft: An organ, tissue or bone that is transplanted from a donor to a recipient.

Histocompatibility/Human Leukocyte Antigen (HLA): HLA testing is a blood test performed on all donors and recipients to determine if there is a matching antigen. The better the genetic match, the more compatible the donor. There are 6 (or more) markers in HLA typing, also referred to as tissue typing or genetic testing.

Home Infusion Services: Intravenous medication given in a person’s home by experienced home nursing care. Home infusion is convenient and comfortable for patients to receive a prescribed medication for desensitization or prevention/treatment for rejection.

Immune System: The system of the body that attacks foreigners such as bacteria, viruses or a transplanted organ.

Immunosuppressant Medication: Oral or intravenous medications that prevent or treat organ rejection or decrease high antibodies. Can be used interchangeably with anti-rejection medication.

Intravenous: Medication or fluid given directly into the blood vessel. Intravenous medications can be given in a peripheral vein (small vessel such as the hand or arm) or central vein (large vessel such as subclavian vessel in the neck area).

Intravenous Immunoglobulin (IVIg): A blood product extracted from the plasma of thousands of donors given IV that decreases or gets rid of antibodies. Antibodies may make it difficult to receive a transplanted organ.

Living Donor (LD): The relative, spouse, friend or anonymous person that donates an organ to someone with end organ failure.

Match: A blood test that evaluates the compatibility between and donor and a recipient.

Mean Fluorescent Intensity (MFI): A blood test that measures the value of the anti-HLA donor antigens. The higher the MFI, the stronger the recipient’s reaction to the donor.

Myfortic: An oral medication used in combination with other anti-rejection medications to prevent or treat organ transplant rejection.

Oral: Any substance such as food, medication or fluid that is ingested through the mouth.

Outpatient Infusion Center (OIC): A clinic set up by a transplant center to infuse intravenous medication that does not require hospitalization.

Organ Procurement and Transplantation Network (OPTN): A transplant network operated by the US Department of Health and Human Services by the United Network for Organ Sharing (UNOS).

Panel Reactive Antibody (PRA): A test performed in a laboratory to determine the number of antibodies present in the blood. The higher the PRA, the more difficult it may be to receive an organ transplant. The PRA is measured at regular intervals and ranges from 0-100%. Previous blood transfusions, transplants or pregnancy can affect PRA.

Prograf: Oral or intravenous anti-rejection medication given to treat or to prevent rejection of a transplanted organ.

Plasmapheresis: A procedure done to remove high antibodies or antibodies caused by certain diseases pre- or post-transplant through an intravenous line. Post-transplant plasmapheresis can be done to treat rejection of a transplanted organ.

Recipient: A person that receives a transplanted organ, tissue or blood.

Rituxan: Intravenous medication given to treat high antibodies Pre-Transplant/Post-Transplant antibody mediated rejection. This medication must be given in a controlled area such as a hospital or OIC.

Threshold: The acceptable value of reactivity determined by a transplant center when looking at MFI reactivity between a donor and recipient. Desensitization procedures attempt to lower the MFI of antigens below the threshold so that a compatible transplant can take place.

Thymoglobulin: An induction medication given intravenously around the time of transplant to prevent acute rejection. This medication can be administered in the hospital, at an outpatient infusion center or in the home.

Transplant: A surgical transfer of an organ tissue or blood, from a donor to a recipient, with end organ failure. (i.e.: kidney, heart, or liver).

United Network for Organ Sharing (UNOS): A private, not-for-profit organization that manages the United States organ transplant system under contract with federal government.

Velcade (Bortezomib): An intravenous, anti-rejection medication used to prevent or treat rejection of a transplanted organ.

Waiting List: Candidates that meet the requirements of a transplant center are registered on the UNOS national list for organ transplant and then wait for a match for a compatible organ.