Post Transplant Care

The length of your stay in the hospital will depend on how fast you are recovering. Your doctor and the transplant team will keep you informed about your progress. Expect it to be around 10 days.

Caring For Your Wound

You will have an incision (or cut) down the centre of your chest. This incision goes through the sternum (or breast ­bone). Your sternum will be held together with wires after the surgery. Your skin will be held together with stitches that dissolve, stitches that need to be removed or metal staples that need to be removed. You will have a dressing on the incision for the first 2 days. You will need to take good care of the wound and follow all instructions that the doctors and nurses give you. Putting pressure on it and handling any kinds of weights need to be strictly avoided.

Exercises

After the surgery, you will feel weak and tired and may not feel like doing anything at all. However, it has been proven that getting you up and about not only makes you feel better, but also reduces the risk of complications, such as pneumonia. A physiotherapist will help you with breathing exercises in the initial stages and will tell you when and how much other exercises you can do later. You have a new heart, so you will be feeling better and will get your strength back faster.

Diet

Initially you will be given liquids such as juices and clear soups, but your diet will quickly progress to solid foods on a low fat, low salt “Cardiac Diet”. A dietitian will decide your diet so that you can meet your needs. Some of the medications you will be prescribed may affect your appetite. Certain drugs can have side effects such as a strange taste in your mouth or increased hunger. But this will eventually subside. The dietician will also give you a detailed diet which you are to follow after you go home.
Handling Changing Emotions

You may have different emotions after the surgery than you had before. Relief, disbelief, joy – lots of emotions will be going through you. You may also have mood swings as a result of medication. Relax. This is normal. Don’t get despondent. Talk to the team about how they can help you, and make sure you have someone to talk to. A support group will await you after you leave the hospital and it’s a great idea to meet others who have been through a similar experience.

Becoming Self-reliant

You will be taught how to take care of yourself and how and when to take your medication. The nurses will show you how to take your blood pressure, pulse, and temperature so that you can monitor your own health. You will also be taught the signs and symptoms of heart rejection and infection, since early detection of problems is so important. At least one other person should be given all this information so that they can take care of you after you go home. The doctor/nurse will outline your schedule for check­ups and blood work.

Your Anti­rejection (Immunosuppressant) Drugs

Rejection is a common complication for most heart transplant recipients. Rejection is caused by the body’s immune system. Your immune system is the body’s defense against infection and disease. Rejection occurs because the immune system recognizes the transplanted heart as “foreign” and so thinks it is doing the right thing in trying to eliminate it. If nothing were done to weaken the immune system, it would eventually damage or destroy your new heart.

To try to prevent your immune system from rejecting your new organ, you will be given a number of different drugs. The doses of these drugs are carefully measured and monitored so that they prevent rejection, but still allow your immune system to recognize and fight infection.
With the use of anti­rejection drugs, your chance for a successful heart transplant is excellent. Remember, you will have to take the anti­rejection medications for the rest of your life.

Various combinations of drugs are used to try and prevent rejection. When you first start taking anti­rejection drugs, the doses will be high. After a short period, as the risk of rejection decreases, the doses will be lowered.

Taking Anti-­rejection Drugs

It is important to take your medications at the same times each day so that you maintain even levels of the drug in your blood. Be very careful of the following:

To ensure that the drugs work properly, you must take them exactly as prescribed.
Never change the dose of your drugs or stop taking them unless directed by the transplant team.
Before taking any new drugs, always ask your doctor or pharmacist to check with a doctor in the transplant unit.

NOT INFORMING THE TRANSPLANT CLINIC THAT THESE DRUGS HAVE BEEN COMMENCED MAY LEAD TO DANGEROUS SIDE EFFECTS

Related Links
Post Transplant Care
Rejection & Infections
Going Back Home – Do’s & Don’ts
Things You Need to Know Post Transplant
Lungs
Intestines
Pancreas

References:
Fortis Memorial Research Institute
www.medanta.org
http://www.bhf.org.uk/