After the transplant
Following your heart-lung transplant, it is likely that you will have to stay in the intensive care unit (ICU) for several days. There are several reasons for this:
- your new organs will be very vulnerable to infection immediately after the transplant, so you will need to stay in a sterile (germ-free) environment
- there is a risk that your body may suddenly reject the new organs, which would require emergency treatment
- you will require additional assistance with breathing and feeding until you begin to recover
It is likely that you will be in some pain after the transplant, so you will be given pain relief as required.
You will then usually be transferred to a general ward within three or four days. There your health will continue to be monitored as you recover from the effects of the surgery. Most people will be well enough to leave hospital within three weeks of having a heart-lung transplant.
The recovery process
Recovering fully from a transplant can be a long and sometimes frustrating process. You may be referred to a physiotherapist, or other specialist in rehabilitation, so that you can take part in exercises that are specifically designed to strengthen your new heart and lungs. This is known as cardiopulmonary rehabilitation.
After having a heart-lung transplant, it may be up to six months before you are well enough to return to your normal daily activities.
During your recovery period, you will need to attend regular check-ups so that the function of your new heart and lungs can be regularly monitored. You may need as many as three check-ups a week during the first few weeks after the transplant. These appointments will become less frequent if you make good progress.
Once you make a full recovery, you will still require regular check-ups on a long-term basis. Depending on your condition, the timing of these can range from every three months to once a year.
Immunosuppressants
After having a heart-lung transplant, one of the biggest risks is that your immune system will regard the new heart and lungs as foreign objects and begin to attack them. This is known as rejection. See Heart-lung transplant - disadvantages for more about rejection.
In order to prevent your new heart and lungs from being rejected, you will need to take medicines, known as immunosuppressants, to suppress your immune system. Immunosuppressants work by interfering with the normal activities of specialised white blood cells called T-cells.
The immune system uses T-cells to kill foreign cells, such as bacteria, viruses and, in the case of transplants, donated tissue, such as your new heart and lungs.
Most people who have a heart-lung transplant need to take a combination of three different immunosuppressants for the rest of their life. However, if you respond well to treatment, the doses of immunosuppressants may be lowered over the long-term.
Immunosuppressants are powerful medicines that can have a range of different side effects. Possible side effects you may experience include:
- increased vulnerability to infection
- weakened bones (osteoporosis)
- muscle weakness
- nausea
- vomiting
- stomach ulcers
- blurred vision
- insomnia
- weight gain
- mood swings
- shaking of the hands
- acne
While these side effects may be troublesome, you should never stop, or reduce, the recommended dose of immunosuppressants because if you do it could lead to your heart and lungs being rejected.
The transplant centre may be able to provide additional treatments to help you to cope better with any side effects that you experience after taking immunosuppressants.
