How can kidney transplant rejection begin soon after surgery?

Kidney transplant rejection can begin within minutes or hours after surgery if the recipient has preexisting antibodies that target the donor's antigens.12

This rapid, antibody-mediated rejection occurs because the recipient’s immune system has been previously sensitized to foreign antigens through events such as prior transplants, blood transfusions, or pregnancy. Unlike cell-mediated rejection, which typically develops over days or months as T lymphocytes infiltrate the graft, this immediate antibody attack is generally irreversible.2

To minimize these risks, medical teams perform careful immunologic matching of donors and recipients before the operation. In cases where a donor is incompatible, specialized desensitization therapies may be used to filter out the harmful antibodies from the patient's blood prior to the procedure.1