What To Expect After a Heart Transplant
In the Hospital
The amount of time a heart transplant recipient
spends in the hospital will vary with each person. It often involves 1 to 2
weeks in the hospital and 3 months of monitoring by the transplant team at the
heart transplant center. Monitoring may include frequent blood tests, pulmonary
(lung) function tests,
EKGs (electrocardiograms),
echocardiograms,
and biopsies of the heart tissue.
A heart biopsy is a standard test used to see
whether your body is rejecting the new heart. It might be done frequently in
the weeks after a transplant. During a heart biopsy, a tiny grabbing device is
inserted into a vein of the neck or groin (upper thigh). The device is threaded
through the vein to the right atrium of the new heart to take a small tissue
sample. The tissue sample is checked for signs of rejection.
Watching for Signs of Rejection
The new heart is a "foreign body," which your immune
system may attack if you're not receiving enough medicine to suppress your
immune system after the surgery. Therefore, you and the transplant team will
work together to protect the new heart by watching for signs of rejection.
These signs include:
- Shortness of breath
- Fever
- Fatigue (tiredness)
- Weight gain (retaining fluid in the body)
- Reduced amounts of urine (problems in the kidneys
can cause this)
You and the team also will work together to manage
the transplant medicines and their side effects, prevent infections, and
continue treatment of ongoing medical conditions.
You may be asked to monitor your temperature, blood
pressure, and pulse when you go home.
Preventing Rejection
You will need to take medicine to suppress your
immune system so that the new heart will not be rejected. These transplant
medicines are called immunosuppressants. They're a combination of medicines
that are tailored to your situation. Often, they include cyclosporine,
tacrolimus, MMF (mycophenolate mofetil), and steroids such as prednisone.
Transplant medicines may need to be switched or
adjusted if they aren't effective or have too many side effects.
Managing Transplant Medicines and Their Side
Effects
You will have to manage multiple medicines. Setting
up a routine for taking medicine at the same time each day and for refilling
prescriptions is helpful. It's crucial to never run out of medicine. It may
help to always use the same pharmacy.
Keep a list of all medicines with you at all times
in case of an accident. When traveling, keep extra doses of medicine with you,
not packed in the luggage. Bring your medicine with you to all doctor visits.
Side effects from medicines can be serious. These
include risk of infection, diabetes, osteoporosis (thinning of the bones),
high
blood pressure, kidney disease, and cancer—especially lymphoma and
skin cancer.
Discuss any side effects of the medicines with your
transplant team, because the dose of a given medicine or the medicine itself
can be changed. Report all new medicines to your transplant coordinator.
Preventing Infection
Some transplant medicines can increase your chances
of developing infections. You may be asked to watch for signs of infection,
including fever, sore throat, cold sores, and flu-like symptoms.
Signs of possible chest or lung infections could
include shortness of breath, cough, and a change in the color of sputum (spit).
The incision must be checked for redness, swelling,
or drainage. It's especially important to look for signs of infection, because
transplant medicines can often mask these signs.
Discuss with your doctor measures you should take to
reduce your chances of developing infections. For example, your doctor may
recommend that you avoid contact with animals or crowds of people in the first
few months after your transplant.
Regular dental care also is important. Your doctor
may prescribe you antibiotics before any dental work to prevent infections.
Pregnancy
Many successful pregnancies have occurred after
heart transplant surgeries; however, special care is important. If you've had a
heart transplant, talk with your doctor before planning a pregnancy.
Emotional Issues
Having a heart transplant may cause fear, anxiety,
and stress. While you're waiting for a heart transplant, you may worry that you
won't live long enough to get a new heart. After surgery, you may feel
overwhelmed, depressed, or worried about complications.
All of these feelings are normal for someone going
through major heart surgery. It's important to talk about how you feel with
your health care team. Talking to a professional counselor also can help. If
you're feeling very depressed, your health care team or counselor may prescribe
medicines to make you feel better.
Support from family and friends also can help
relieve stress and anxiety. Let your loved ones know how you feel and what they
can do to help you. |