organ transplant

Life on Anti-Rejection Medications After Transplant

Our bodies are wired to defend themselves against foreign invaders. After a patient undergoes an organ transplant, the body responds to the new organ as if it were a foreign object. The immune system goes into overdrive trying to reject it. This is why it is vital for transplant patients to take anti-rejection medications or immunosuppressant drugs immediately following transplant surgery and for the rest of their lives.

Potential Side Effects of Anti-Rejection Medication After Transplant

While necessary to keep transplant patients alive, anti-rejection medications do come with a few potential side effects. This is especially true of the drug tacrolimus, which is one of the most common anti-rejection medications available. Because this medication suppresses the immune system, the patient has a higher risk of infections and infectious complications. The drug can also cause high blood pressure and gout, have adverse effects on kidney function, and potentially create blood cell issues.

“The side effects of anti-rejection medications may feel overwhelming at first,” states Dr. Ram Subramanian, Associate Professor of Medicine and Surgery and the Medical Director of Liver Transplantation at Emory University School of Medicine. “That’s why we closely monitor our post-transplant patients throughout their life and provide intense post-op care.”

The Importance of Proper Follow-Up Care

After a transplant, patients will need to follow up with their medical team regularly, especially during the months following the transplant.

“In the first few months, we see patients almost every week,” notes Subramanian. “In the first month after the transplant, we get labs and run blood tests up to three times a week. As time goes on, we allow more time between follow-ups, but we never really stop monitoring these patients.”

Your physician will also let you know which other drugs could interact poorly with your medication and alert you to any necessary lifestyle changes. For instance, grapefruit juice affects the body’s absorption of anti-rejection medications and should be avoided. And, because these life-saving organs require extra care, medical professionals will insist patients abstain from alcohol after a liver transplant.

Medication Education

Since patients must start taking pharmaceuticals on a daily basis, there’s an education process that occurs immediately after their transplant.

“Before discharging a patient, our team sits down with him and his family to review the medications. Everyone needs to know what the medicine looks like, the frequency at which it should be taken, as well as what time of day,” explains Subramanian. “It’s very detailed training for the patient and his family.”

It’s absolutely vital patients don’t skip any days of their medication or stop taking it, even if they appear to be in good health. Without the medication, the body can still reject the organ at any time, and the signs of rejection are very subtle.

Living a Long Life on Anti-Rejection Medications

If patients take care of themselves and are compliant with their anti-rejection medications, they can have a long life after organ transplant.

“I recently saw someone in the clinic who does an excellent job taking his medicine and caring for his body,” notes Subramanian. “His liver transplant took place 30 years ago and he’s still here thanks to his anti-rejection medication.”

To hear more from Dr. Subramanian about living life on anti-rejection medications, listen to his podcast on this topic.

For more information about organ transplant and the Emory Transplant Center, visit

About Dr. Subramanian

Dr. Ram Subramanian is Associate Professor of Medicine and Surgery, and the Medical Director of Liver Transplantation. In his dual role as a transplant hepatologist and an intensivist.

Dr. Subramanian is involved in the inpatient care of patients before and after liver transplantation. His clinical and research interests are focused on critical care issues related to hepatic failure and liver transplantation.


Choosing a Transplant Center: Survival Outcomes Data

Organ transplantation is one of the greatest advances in modern medicine. Just the idea of replacing an organ in the body with another one via transplant is an overwhelming concept. Therefore, it is no surprise that those who are faced with a condition that may require one may feel scared and helpless. If you or a family member are facing an organ transplant in the near future, here are a few suggestions to help you choose the right transplant center for your care.

One of the biggest decisions you will make is choosing a center to have your transplant surgery. With more than 250 transplant centers in the U.S., where do you start? Many patients simply choose the facility closest to them, but there are several questions you should ask before making your final decision on a transplant center:

  • What is the transplant center’s experience with performing transplant (transplant surgery volumes), and what are their survival outcomes?
  • Is the center within the network of your health insurance?
  • If the center is not close to your home, can your family/support system stay near the transplant center without causing an undue burden?
  • Can you easily reach the transplant center for all appointments before and after the transplant?
  • Do you feel comfortable speaking with physicians and the transplant team?

The first question on the list is one of the most important factors when making the decision. Finding and understanding transplant volume and survival outcomes data can be complicated, but the good news is that there is a resource that exists to help you. And it is right at your fingertips. The Scientific Registry of Transplant Recipients (SRTR) provides a website that lists patient and graft survival outcomes for each transplant program across the nation in an easy-to-understand format. Before making your decision, be sure to visit the SRTR website and review your program’s data.

Scientific Registry of Transplant Recipients (SRTR)

The Scientific Registry of Transplant Recipients (SRTR) is a national database of transplant statistics. Data in the registry are collected by the Organ Procurement and Transplantation Network (OPTN) from hospitals and organ procurement organizations (OPOs) across the country. Every six months, SRTR uses the collected data to calculate transplant program volumes and survival outcomes, and then makes it available to the public on its easy-to-navigate website (

Emory Transplant Center Results

At the Emory Transplant Center, we’re consistently taking steps to improve transplant survival rates and, hopefully, remove some of the fear for our patients. We’ve just received results from the October 2018 release of the SRTR’s transplant program-specific report, and are pleased to highlight a couple of results from our kidney and liver transplant programs. Both programs have demonstrated consistently strong and in some cases better-than-expected patient outcomes.

Emory Kidney Transplant Program



  • In 2017, our kidney transplant team performed 235 adult kidney transplants, and 15 simultaneous kidney/pancreas transplants. This positions the Emory Kidney Transplant Program among the top 15 centers nationally for kidney transplant.

Living Donor Program

  • We performed 82 adult kidney transplants from living donors in 2017. Of those, 25 were transplanted through our paired donor exchange program; therefore ranking Emory’s Kidney Transplant Program as the 5th largest paired donor program nationally through the National Kidney Registry (NKR).

Survival Outcomes

  • Emory’s risk adjusted 3-year patient and graft survival rates for living donor kidney transplants are higher than our expected rates at 98.28% and 93.33%, respectively.









*Published in October 2018 Scientific Registry of Transplant Recipients (


Emory Liver Transplant Center



  • In 2017, our liver transplant team performed a total of 125 adult liver transplants. This positions the Emory Liver Transplant Program among the top 12 centers nationally for liver transplant volume.

Time to Transplant

  • Of our 125 patients transplanted, 40% received a liver transplant within one month of listing, and a total of 56% were transplanted within three months of listing.

Survival Outcomes

  • Emory’s risk adjusted one-year patient and graft survival rates for liver transplantation remain higher than our expected rates at 93.10% and 92.79% – with both being higher than the national average as well.
  • We are particularly proud of the fact that both of our 3-year risk adjusted patient and graft survival rates are well above our expected rates, being statistically higher than expected (p<0.05).









*Published in October 2018 Scientific Registry of Transplant Recipients (


About Emory Transplant Center

As one of the top 15 transplant facilities in the nation, Emory Transplant Center is at the forefront of clinical excellence and pioneering new transplant therapies. We offer cutting-edge technology and superior outcomes in heart, kidney, liver, lung and pancreas transplantation.

Our patients come from all over the nation seeking the highest level of expertise and a full-service organ transplantation program that only an academic medical center like Emory Healthcare can provide.

To learn more about Emory Transplant Center, visit or call 855-366-7989.