Because there‘s not just one type of immunosupressants and rejections.
There are a ton of different things that can cause your immune system to reject an organ. A „match“ just means the amount of those factors is rather low, so immunosupressants can prevent the rejection.
The theoretical perfect match, where your body accepts it as its own doesnt exist. Even identical twins can reject each others organs. Only lab-grown organs from your own cells can be implanted without immunosupressants. Those are currently limited tl simple things tho, for example cartilage in a joint (i have had my kneecaps cartilage replaced)
Furthermore immunosupressants come in various groups, all of which only block certain parts of the immune system. If you have a really good match your medications only need to block some part of your immune system, so it‘s not as compromised.
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