Post-Operative Intensive Care
After surgery you will recover in the Intensive Care Unit. You will be cared for and monitored very closely and your new heart will be supported with intravenous medications for one or two days. Antibiotics are given during and after the transplant to help you ward off infection. You will spend most of your time in bed, but as you recover and equipment is removed, you will be able to sit in a chair and walk around your bedside. Your family will be allowed to visit, but because of your high risk for infection, visits must be limited.
Step-Down Care
From the intensive care unit, you will move to what we call the step-down unit. You will continue to be closely monitored but will increase your activity. Education and physical therapy, which began in the ICU, are intensified during this phase of your recovery. Your doctor will determine how much you can walk, which helps to prevent pneumonia and to increase blood circulation to your new heart.
Pre-Discharge Care
We continue to watch you closely for signs of rejection, infection or other complications. Physical therapy continues with a goal to have you walking and able to climb stairs before you leave the hospital. Adult heart transplant recipients are usually hospitalized for 10 to 15 days after the operation. If you need a longer period before going home, we will arrange for you to stay for a short time at a rehabilitation facility.
Early Post Hospital Care
Most heart transplant recipients immediately feel benefits from their new heart. However, your energy level will rise and fall, especially for the first six weeks or so. Also, it takes about eight or nine weeks for the bones and tissues in your chest to thoroughly heal. Until then and for several weeks after, you shouldn’t drive or perform other activities that stress your arms and upper body.
Since the greatest risk of rejection is within the first months after transplant, you’ll be taking high doses of immunosuppressant drugs. This means your risk of infection will be at its peak during this time, so you’ll want to continue to limit your visitors. Your transplant team will see you many times during the first few weeks after your discharge to run tests, adjust your medications and take care of any complications that may arise.
Your Long Term
During these first few months after your transplant, you may feel overwhelmed by your many appointments and your daily regimen of medications and physical rehabilitation. In fact, about one-third of all patients who have heart surgery of any type suffer from depression. We don’t know why this is so prevalent, but we do know that it passes. Plus, it’s very treatable with medication. Just realize that these feelings are common. In a relatively short time – about six to eight weeks after your transplant — your life will start to return to normal.
Once you’re past the critical period for rejection, your doctors will reduce your immunosuppressant drugs to the lowest levels possible. This is a balancing act that will continue for the rest of your life. Over time your immune system will gradually become more effective, but you will always be at higher risk of infection than others.
Your transplant team will continue to work closely with you to manage your condition, including the potential side effects caused by immunosuppressants as well as any psychological stress that continues to linger. We have found that once a patient and his or her family are able to settle into a routine, most cope well with the emotional side of the changes a transplant brings to everyday life.
On a daily basis, you will:
- Take your medications as prescribed
- Eat a healthy, balanced diet
- Do regular exercise approved by your doctor
- Monitor your blood pressure, weight and temperature
- Take infection-avoidance precautions
- Be aware of anything unusual and report to your doctor
Periodically, you will be tested. These tests will include blood work and heart biopsies to monitor rejection.
Most transplant patients are able to lead an active life. Many go back to work and even participate in moderately vigorous sports. You will be encouraged to do whatever your doctors consider medically safe.
Home Care through Visiting Nurse Service
The Visiting Nurse Services offers help for patients who are discharged from the hospital following an acute episode of heart and/or lung disease.
Our multi-disciplinary team of specially trained professionals monitors the patient and provides services tailored to each patient’s specific needs.