What your can expect after your transplant

Post-tranplant Recovery
Shortly after your transplant, you will be taken to the intensive care unit (ICU) so hospital staff can watch you very closely. You might be connected to a variety of machines and other devices. These can include cardiac monitors, intravenous lines, tubes, and drains. The period immediately following transplant is a very critical time for you. Only your immediate family will be able to visit you, and only for short periods of time. As your condition begins to stabilize, you will be transferred to a regular room where you can continue your recovery process. At the same time, you and your family will be taught how to care for you when you return home. Most patients are discharged from the hospital 5 to 12 days following transplant.

Recovery Period
Before you leave the hospital, you and your family will be given an orientation including proper instructions on how to care for you when you return home. The goal of the postoperative period is to provide continuity of care by having your transplant team work with you and your primary care Physician. Most patients recuperate fully within the first 3 months post transplant and are then able to return to work and live normal, active lives.

Complications
You should not be surprised if there are some complications following your transplant-complications following any type of surgical procedure are common. Most complications you may experience will be minor and won’t require complex therapies. However, there are some more serious complications that can occur.

These include the following:

• Bleeding:
  This is less dangerous than other potential complications. It can occur where your blood vessels and the donor blood vessels were sewn together.
• Rejection:
  This is not an uncommon complication following a transplant. Your body’s immune system is naturally trained to recognize your new organ as a foreign object and subsequently attack it. Most patients will experience small rejection episodes that can be easily controlled by medications. Since most rejection episodes occur within the first few months after transplant, you will be closely monitored during this time so that any possible rejections can be diagnosed and treated early. The best way for you to prevent a rejection from occurring is by taking the medications prescribed by your doctor.
• Neurological Complications:
  Psychoanalysis of patients receiving transplants shows that most patients experience an improvement in depressive cycles and an increase in energy within the first 6 months post transplant. Neurological complications may occur in transplant recipients. Most of these problems are mild, such as recurrent headaches and tremors. However, other, more serious neurological complications can occur, including paresthesias, altered mental status, seizures, and coma. In most cases, the patient is referred to a neurologist who will evaluate the cause of the complication and initiate the appropriate therapy. A decrease in cyclosporine or tacrolimus dose may be prescribed to ensure that the neurological complications are not a side effect of either of these medications.
• Pulmonary Infiltrates:
  Pulmonary infiltrates develop in 44% of patients who have been admitted into the ICU (usually due to pneumonia and pulmonary edema. Of the cases of pneumonia contracted in the ICU, 47% occur within the first 30 days post transplant. Patients who are predisposed to pulmonary problems, such as asthma, and those who receive large blood transfusions during their transplantations are more vulnerable to developing this type of complication. Pulmonary infiltrates are quite serious and must be assessed and treated immediately.
• Primary Graft Dysfunction:
  Primary graft dysfunction (PGD) is a major cause of early mortality and retransplantation. The incidence of PGD is increased by donor factors, such as advanced age and the length of time the organ is preserved before it is transplanted into the recipient’s body.
• Infection:
  Infection is a potentially life-threatening complication after transplantation, generally occurring in the first 2 months post transplant. Approximately 50% of transplant patients will develop some type of infection. Infections often occur because your immune system’s strength has been reduced to prevent organ rejection. There are three types of infections: bacterial, viral, and fungal. In the first month, the most common infections are related to the surgery, and can include bacterial infections of the wound and the intravenous line site. Other infections common to transplant patients are cytomegalovirus, Pneumocystis Carinii, and candidasis (thrush). You will receive anti-infective medications post transplantation to prevent these infections.