As you recover from surgery, our heart transplant team will follow you closely. Follow-up care after a transplant is individualized depending on your needs, but you will likely experience the following:
- The first four weeks: You will have biopsies and clinic visits weekly after you go home from the hospital.
- Routine labs: You will have monthly lab testing to monitor anti-rejection medication levels as well as other labs to monitor the effects of the medications.
- Months two and three: We begin spacing out your biopsies and your clinic visits to every two to three weeks.
- During the first year: We will see you monthly in clinic visits. You will continue to have periodic heart biopsies and blood testing to monitor for possible rejection.
- Annual testing: Annual testing consists of a heart catheterization to check for the presence of coronary artery disease (blocked arteries), heart biopsy, blood work, bone density scanning and an echocardiogram.
Medications After Transplant
Our transplant team will help you manage and understand your medications following surgery. As a transplant recipient, you will need to take immunosuppressive (anti-rejection) medications for the rest of your life to prevent organ rejection.
Here are some things you need to know about your post-transplant medications:
- These anti-rejection medications suppress your immune system so your body doesn’t reject your transplanted heart.
- Because your immune system is suppressed, you will be more prone to infections, especially during the first year after transplant.
- It is critical that you take all your medications as prescribed.
- You will need to carefully monitor and report any unusual side effects to your transplant coordinator. Side effects vary by dosage and type of the medication. Ask your transplant coordinator or transplant doctor any question you have about your medications.
- Never miss doses of your medications or stop your medications without approval from your transplant team.
- Although your medication regimen will be complex, rest assured your transplant team will teach you what you need to know and how to properly take your medications.
Monitoring for Signs of Rejection
Because your body sees your transplanted heart as a “foreign object”, it may try to reject your heart, much the same way if does with infections. Rejection is not uncommon. The risk of rejection decreases over time but can occur at any time. It’s important to follow all medication regimens and instructions to help prevent rejection and to recognize the early signs of rejection. We are highly skilled in treating rejection if it occurs; the key is to prevent rejection as much as possible.
Symptoms do not always accompany rejection but here are some ways to help identify and manage possible rejection. If you experience any symptoms of rejection, call your transplant nurse coordinator immediately:
- Low-grade fever
- Shortness of breath
- Fast heartbeat or skipping some beats
- Swelling of hands or feet
- Sudden weight gain
- Drop of blood pressure
- Not feeling "quite right" or flu-type aches and pains
Minimizing Infection Risk After Transplant
The same medications that help prevent rejection also increase your risk of infection. For the first 12 months after your transplant, the likelihood of rejection is highest, so you will be taking higher doses of these medications. This makes you even more vulnerable to infections. There are ways to help protect yourself from infection. You will be asked to follow these guidelines:
- Take and record your temperature daily.
- Wash your hands frequently and avoid contact with people who are ill. Alcohol gel is effective in preventing the spread of germs.
- Wear a mask in any crowd. You will be provided with masks to wear when you leave the hospital following your transplant.
- Practice good dental hygiene. You will need antibiotics prior to all dental procedures.
- Avoid contact with dust and dirt, which may carry a fungus that is dangerous to people taking immunosuppressive medications. Do not work in or visit any form of a construction site. Avoid gardening for the first after your transplant.
- Do not have a humidifier in your home.
- Do not use pepper for the first three months after transplant. After this time, you may use pepper, but replace your pepper supply every three months. Old pepper may contain a fungus that is dangerous to people taking immunosuppressive medications.
- You may have a dog but other pets will put you at risk for infections. Avoid cats, reptiles and birds.
- Undergo recommended immunizations (e.g., influenza, pneumococcal)
You should call your transplant coordinator immediately if you have any of the following symptoms which could indicate you have an infection:
- Fever over 99°F
- Signs of illness (cold, flu or extreme tiredness, or a cough that lasts more than 2 days)
- Sudden weight gain
- High blood pressure
- White patches on your tongue or mouth
- Cloudy or foul-smelling urine
Read more about your health care after heart transplantation.