Things You MUST Know After a Lung Transplant

You are the most important member of the transplant team. Monitoring your health after discharge will become part of your daily routine. You will monitor your pulmonary function, weight, blood pressure and temperature daily. The transplant team will give you a transplant manual in which to record this data.Please bring your transplant manual with you every time you go to the hospital.The transplant team counts on you to notify them of changes in your health which might indicate a problem.

Spirometer

Your pulmonary function tests are the most sensitive indicators of rejection and infection episodes. You will monitor your pulmonary function every day at home using a spirometer. The transplant coordinator will teach you how to use your spirometer.

The Micro-Direct spirometer is a hand-held spirometer. Every day you will blow three tests. The tests which you record in your transplant manual are the best FEV and the corresponding FVC. If you experience drops in the FEV and FVC for three consecutive days, you should report it to the transplant team.

Blood pressure

You will obtain an automatic blood pressure cuff. You will monitor your blood pressure every day. If you are taking medicine for high blood pressure, you should take your blood pressure at least one hour after taking your medicine.A blood pressure that is significantly higher or lower than your usual values should be reported. Contact the transplant coordinator if your blood pressure readings are greater than 140/90 for three days and if they are ever less than 90/60.

Temperature

You will monitor your temperature every morning. You should also take your temperature if you feel feverish. A digital oral thermometer is the easiest to read.Make sure you do not eat or drink anything for 20 minutes before you take your temperature. Ear thermometers are not recommended. Temperatures over 99.5 degrees Fahrenheit should be reported to the transplant team.

Weight

You will weigh yourself daily. You should weigh yourself early in the morning after voiding, but before eating. A weight gain or loss of five pounds should be reported to the transplant team.

Activity

During the first six to eight weeks after transplant you need to limit some activities while your wounds heal. In general:

  • Avoid lifting anything heavier than 10 pounds.
  • Avoid pushing or pulling on heavy doors or furniture.
  • Avoid strenuous activities such as tennis, bowling, and heavy house work oryard work, such as pushing a vacuum cleaner or lawn mower.
  • Driving is not allowed immediately post transplant.

After transplant your physical therapist will design a rehab program tailored to your needs, help you plan an independent home exercise program and establish a long term exercise program.Regular exercise should become part of your daily routine when you return home. Indoor and outdoor sports are fine. Swimming, in the ocean, a lake, or a pool, is a good form of exercise and safe for most transplant patients.You may take baths or showers unless your transplant team tells you otherwise.Use a mild soap without heavy perfumes. Gently massaging your incision while you bathe may help it to fade more quickly.

Sexual relations

Sexual relations may be resumed when both you and your partner feel ready.You may find that some positions are more comfortable than others while your wounds heal. Female patients should use birth control. Pregnancy after transplant carries significant risks to both the mother and baby. Male patients should know that the effects of immune suppressing medicines on sperm are not fully understood. Please discuss which birth control methods you plan touse with the transplant team.

Protective precautions

You should avoid other people with contagious infections. It will be impossible to avoid every common cold virus. Careful hand washing and keeping your hands away from your face should help minimize the threat of catching colds. Children with usual childhood diseases are not usually a threat, but check with the transplant team about any special precautions.

You should wear a snug mask over your mouth and nose when coming to the hospital and attending support group during the first 3 months after your transplant. You should also always wear a mask when working in the yard or flying in a commercial air plane. You do not need to wear your mask in public.You should go about your day without undue fear of catching an infection from the general public.

We strongly discourage working in any mouldy environments (crawl spaces, etc.)or working with fresh soil or mulch, or clearing gutters.Normal, routine household cleaning is enough. Dishes do not need to be sterilized. Sheets and towels do not need to be changed every day. Water does not need to be boiled or bottled; you may drink water from the faucet.

You may keep your cats and dogs. If you have other kinds of pets, discuss them with your transplant coordinator. You should not change kitty litter or clean birdcages as an infection called toxoplasmosis is found in cat and bird faeces.

Vaccinations

You should get an annual flu shot and get the pneumonia vaccine every five years.Live virus vaccines should not be given to you, your children or to grandchildren you see regularly. The polio vaccine should be given as an injection instead of orally. You should not change diapers of children who have gotten the oral polio vaccine. Check with your transplant team before getting any vaccinations or traveling to foreign destinations.

Dental work

Be sure to tell your dentist that you are taking immunosuppressant medicines.You will need to have antibiotics before and after having any dental work. The antibiotics will help to prevent bacteria from your mouth from causing an infection.

Sun exposure

Transplant patients are much more likely to have skin cancers than the general population. Many of the medicines taken after transplant make sunburn occur more easily. It is important to limit your sun exposure. If you must be out in the sun, it is important to use sun screen with an SPF factor of 30 or more. Hats with wide brims and clothes with ultraviolet protection are also recommended.

Diet

What you eat is important to your health. Some of the medicines you take after your transplant may increase your appetite (prednisone), cause problems with blood sugar (cyclosporine, tacrolimus, and prednisone), or cause fluid retention (prednisone,blood pressure medicines). Weight gain after transplant occurs commonly. A well balanced diet is recommended. Choose foods from the four food groups: bread and cereals, four or more servings; fruits and vegetables,four or more servings; milk and dairy products, two to four servings; and meat and proteins, four to six servings. You should limit fats, refined sugars, and salt.During your hospital stay you will be given a low white blood count diet. This diet has no raw foods. Fruits and vegetables will be cooked or peeled. Your transplant coordinator will discuss dietary restrictions with you before you go home.After a few months, you may eat most foods.

Uncooked fruits and vegetables are fine as long as they are cleaned well. You should not eat from the salad bar in a restaurant.

Uncooked fish such as raw oysters, sushi, or sashimi should also be avoided.

Salt

Salt, specifically sodium, should be used sparingly. Prednisone makes the body retain sodium and water. Swelling in your feet may be made worse by excessive sodium intake. Too much sodium may also cause problems with high blood pressure. To limit your sodium intake, do not add salt to your food at the table.Canned and prepared foods are high in salt. Fresh or frozen foods have lower sodium than canned foods. Food from fast food restaurants is quite high in sodium.
Fat and Cholesterol

Fat and cholesterol should be limited in your diet. High blood cholesterol level shave been directly related to developing coronary artery disease. Some of the medicines taken after transplant may cause high blood cholesterol levels. Blood cholesterol levels can be lowered by limiting fat and cholesterol in your diet.Even if your cholesterol level is normal, you should limit the amount of fat in your diet. Cholesterol is found in all animal fats, such as butter. Unsaturated fats made from vegetables may be used, but should also be limited.

Alcohol

Alcohol should be prohibited.

Related Links
Lung Transplant
Reasons For Transplant
Lung Transplant Evaluation, Allocation, Scoring & Matching
Waiting For An Organ Donor
Getting The Call
The Lung Transplant Operation & Post-Operative Stay
Living With New Lungs – Rejections & Infections
Clinic Visits & Studies