What is the most common cause of death organ transplant recipient?

Answer 1

I'm assuming you're referring to a time frame which is relatively soon post-transplant, rather than ten or twenty years down the line, since that would involve predicting the future (which I can't do) rather than looking at data (which I can do).

The most common cause of death is not "heart-attack on the operating table", unlike some popular culture would suggest. These days the numbers of people surviving the actual surgery are very good.

The time period with the highest mortality rates occur within the first month of transplant, with the risk being the worst within 10 days of transplant, reducing a little within the 10 days-14 days mark, but becoming much safer it you get to 28 days and beyond.

The main causes of death are things which result in the graft (transplanted organ) not functioning correctly, not including rejection. There is a certain element of randomness as to whether an organ will work correctly upon transplantation; sometimes an organ will appear perfect, be transplanted perfectly within the best-time frame, but not function at all. It is these situations which cannot be controlled for and do pose a risk to the patient's life. If it's a kidney transplant, it's back to dialysis for them. If it's a heart, liver etc.., it gets a bit more tricky; patients can be stabilized for a few days in the hope of another transplant, or the hope that the organ begins to work. However very few patients survive those situations, and it is in these situations where 90% of early mortalities lie.

Besides that risk, blood clots around the transplanted organ pose the next risk to life. A blood clot can block the blood supply to an organ, causing it to fail. Although post-transplant drug regimes are designed to minimize the risk of blood clots, but it does still happen. An equivalent risk to this one is the risk of an infection, which can be difficult (but not impossible) to treat in a heavily-immunosuppressed post-transplant patient.

Organ rejection isn't as huge a cause of death as you may think. Although it does happen to many people, transplant centres have lots of experience at treating it.