Surgery & Postoperative Care Care and Concerns

We want you to feel comfortable living with your new organ. We want you and your family to be prepared to care for the new you. Answers to some frequently asked questions follow, but we encourage you and family members to speak with us about any concerns you have well before you leave our inpatient care.

Rejection, Immunosuppression, and Infections

Your immune system recognizes and attacks anything different from the substances normally present in the body, even those only slightly different like your transplanted heart. Rejection is the term used when your body's immune system is attacking your transplanted organ. Nearly all patients will experience at least one rejection episode, especially in the first year after transplantation.

After your heart transplant, you will be taking immunosuppressant, or anti-rejection, medications for the rest of your life to prevent your immune system from targeting your new heart as a "foreigner," and damaging it. Sometimes, the immune cells attack even though you are taking these medications.

Rejection occurs most often in the first six months after transplant. The chance of rejecting your new heart decreases with time, but rejection can occur at any time after transplant. Endomyocardial or cardiac biopsy is the way your transplant team monitors your heart for rejection. Because rejection can occur without any symptoms, cardiac biopsies are performed with regularity in the first year after transplant.

Dental Care and Infections

Your mouth is a potential source of infection because so many bacteria and fungi are normally present there. This is why we insist that you have a dental evaluation before your surgery. After transplant, it is important that you have regular checkups and maintain good dental hygiene.

Schedule of Follow Up Care after Your Operation

After your transplant, as you are ready to leave the Hospital, you will be given a schedule of appointments for follow up examinations and biopsies with your transplant doctor and nurse coordinator. These appointments are critically important. The examination and diagnostic tests performed during them tell us is there is any indication of rejection and allow us to adjust your medications as needed.

Taking Your Medications

You know that after your heart transplant, you will be taking many different medications, each prescribed to you for a specific therapeutic reason. But, what specifically are all these medications we've been discussing in general so far? They fall into four categories:

1. Immunosuppressants: Drugs and agents which shut down your body's natural immune responses that would damage your new heart.
2. Antibiotics, Antivirals and Fungicides: Drugs that intercede to fend off infection because your natural immune responses are now disabled.
3. Vitamins, Minerals and Nutritional Supplements: Compounds to aid your body in its efforts to heal and maintain proper functioning.
4. Coronary-Disease Preventing and Antihypertensive Medications: drugs to prevent coronary artery disease and regulate blood pressure.

You will be taking the highest amount of medications immediately following your operation. Over the first year, we begin to lower some dosages and possibly discontinue certain medications.