Post Operative Care
After lung transplant surgery, the patient will go to an intensive care unit (ICU) to be monitored closely. The length of time he/she will spend in the ICU will vary based on his/her unique condition. After the patient is stable, he/she will be sent to the special unit in the hospital that cares for lung transplant patients.
Patients will continue to be monitored closely. Family members will be educated on all aspects of caring for the patient during this time. This will include information about medications, activity, follow-up, diet, and any other specific instructions from your transplant team.
What is rejection?
Rejection is a normal reaction of the body to a foreign object. When a new lung is placed in a patient's body, the body sees the transplanted organ as a threat and tries to attack it. The immune system makes antibodies to try to destroy the new organ, not realizing that the transplanted lung is beneficial.
To allow the organ to successfully live in a new body, medications must be given to trick the immune system into accepting the transplant and not thinking it is a foreign object.
What are the symptoms of rejection?
The following are the most common signs and symptoms of rejection. However, each patient may experience symptoms differently. Symptoms may include:
- fever
- chills
- flu-like aches
- decreased urine output or fewer wet diapers than usual
- shortness of breath
- pain over the transplanted lung
The transplant team will instruct family members on who to call immediately if any of these symptoms occur.
What is done to prevent rejection?
Medications must be given for the rest of the patient's life to fight rejection. Each person is unique, and each transplant team has preferences for different medications. Some of the anti-rejection medications most commonly used include the following:
- cyclosporine
- tacrolimus
- mycophenolate mofetil
- prednisone
- azathioprine
Because anti-rejection medications affect the immune system, people who receive a transplant will be at higher risk for infections. A balance must be maintained between preventing rejection and making a transplant patient very susceptible to infection. Blood tests are performed periodically to measure the amount of medication in the body to ensure a patient does not get too much or too little of the medication. White blood cells are also an important indicator of how much medication a patient needs.
What about infection?
The risk of infection is especially great in the first few months because higher doses of anti-rejection medicines are given during this time. A lung transplant patient will most likely need to take medications to prevent other infections from occurring. Some of the infections a patient will be especially susceptible to include oral yeast infection (thrush), herpes, and respiratory viruses.
Lung transplant follow-up
Each patient will have very close follow-up with the transplant team after leaving the hospital. This will allow for close monitoring of the patient and the function of the transplanted lung.
Follow-up visits may include the following:
- complete physical examination
- chest x-ray
- blood work
- lung function tests
- continued education for you and your child
- medication changes
Patients who have received a lung transplant will need life-long follow-up with physicians who are specialized in transplant medicine. Keeping appointments with your transplant physician, as well as maintaining contact with the transplant team when signs and symptoms of rejection occur is vital.
Family members, friends, and the recipient, are the first line of defense; they must understand and recognize the signs and symptoms of rejection, and report them as soon as possible to the transplant team.