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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Transplant

Your Lung Transplant (6686)

Your Lung Transplant (6686) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Transplant

6686











Your Lung Transplant


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Your Lung Transplant


We cannot say how long you will be in the hospital after your lung transplant because each
patient and each transplant is unique. You should plan on at least 7-14 days. While you are in
the hospital you will be very busy. You will be going to therapy, walking in the halls, going for
chest x-rays and pulmonary function tests. Your nurses will want to get you out of your bed and
chair to walk a number of times daily in order to prevent pneumonia and blood clots. You may
still be on the ventilator and the nurse may have you sit on the side of your bed. The more time
you spend out of bed, while having enough rest periods in between, the better your new lungs
will perform. You will begin to walk in the hallway 3 to 4 times a day. Most of your day will be
out of your bed, in a chair, or walking as you are able to increase your activity. You will be
offered pain medicine regularly. Do not hesitate to use pain medicine to keep moving. Your
nurses and transplant coordinators will begin to teach you about the medicines and treatments
needed for a successful lung transplant recovery. You will begin taking medicines to prevent
rejection, to prevent infection, and supplements while you are in the hospital which will last your
lifetime.

◙ The Intensive Care Unit (ICU)


After the transplant, the surgical team will move you from
the operating room to the ICU. You will be asleep. You
will have a breathing tube, several intravenous (IV) lines,
and drainage tubes in place. These are all placed during
the transplant to help you breathe, monitor your vital signs,
deliver medicines, and remove fluid from your chest.

As you wake up, you will hear the sounds of the ICU -
beeps and alarms, bubbling from your chest drainage
system, and people talking. Often people can hear before they open their eyes and move their
muscles. Your nurse will be asking you to open your eyes and move your fingers and toes.

Because patients are often drowsy and confused while waking up, your hands may be gently tied
down to protect you from injury. This will also prevent you from accidentally pulling out your
lines and tubes. This is needed the first night after surgery or until you are fully awake and your
breathing tube is taken out.





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Breathing (Endotracheal) Tube

Before surgery, a breathing tube will be put through your mouth and into your trachea
(windpipe). The ventilator (also called a vent or respirator) is a machine that provides breaths of
oxygen and pressure through the tube until you are breathing well on your own. When you
wake up, this tube will still be in place. It will be uncomfortable. During this time, it is vital to
relax and let the ventilator help with your breathing. You may feel like you are choking or
gagging. The nurse will reposition and assist you to feel more comfortable. Your nurse or
respiratory therapists will suction the breathing tube to keep your trachea/airway (windpipe)
clear of secretions. This can feel like your breath is being taken away, but your nurse will be
constantly watching your oxygen levels during the suction procedure. The breathing tube will be
removed when your new lungs are ready to safely function (oxygenate and ventilate) on their
own.

While the breathing tube is in place, you cannot eat, drink, or talk. The nurse will ask you simple
yes or no questions so that you can nod your head to answer. If you are able to, you can try to
write notes with a pen and piece of paper. It is common for patients to experience hand tremors
after transplant which do not allow them to write notes legibly. This will subside as the anti-
rejection medicine levels decrease and your body gets used to new medicine. Once the breathing
tube is out, your diet will change slowly based on your ability to swallow, digest food, and have
bowel movements.

When the doctor decides you are ready to breathe on your own, the process of weaning will start.
Weaning is when the respiratory therapist will turn the ventilator down to its lowest settings and
the nurse will assess how well your new lung(s) do. After a time, most often 30 minutes to 1
hour, blood gases will be sent to see how you are doing, breathing almost on your own. If the
blood work returns with adequate values, the breathing tube will be removed.

Breathing Treatments

Secretions or phlegm will be harder to cough out after having a transplant.

You will receive drugs called bronchodilators to help open up your lung airways. The
respiratory therapist will be working with you every four hours while you are an ICU patient.

After the breathing tube comes out, you will be placed on oxygen – either by a small plastic tube
in your nose or a mask. You will need to work very hard at coughing and deep breathing to keep
your lungs clear. You will be shown how to measure the amount of air you can blow out of your
lungs. A small device called a spirometer does this. This test is very helpful in monitoring your
lung function.

Arterial Line

This is similar to an IV. It is placed in a wrist or leg artery to constantly measure your blood
pressure. Blood samples can be taken from this site without poking you with a needle. This will
be removed a couple of days after your transplant.

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Pulmonary Artery Catheter

During your transplant, this soft, easy to bend tube is placed into a neck vein. It goes into your
heart. It measures how well your heart is working and helps us make decisions about medicines
and other treatments. When your heart and lung pressures are stable, the catheter is removed.

Chest Tubes

These are placed during the transplant to remove extra fluid and air from the chest. The fluid
drains into a collection chamber at the side of your bed. You may hear a soft bubbling sound
coming from this chamber. Some patients find this sound soothing. The tubes remain in place
for a number of days after transplant until the drainage stops and your lungs are fully inflated.

Bladder Catheter

This small tube is put into your bladder to collect urine into a bag. Measuring the amount of
urine you make helps us to know how well your kidneys are working. Sometimes patients feel
the urge to go to the bathroom even though a urinary catheter is draining their bladder. This is
normal. The catheter will be removed once you are alert and can be helped to the bathroom.

Heart Monitor

This tells us about your heartbeat and your blood pressure. It is normal
for alarms to sound at times when you are moving around. Your nurse
will be closely watching the monitors both at your bedside and at the
nurses’ station. The nurses are able to interpret the importance of each
alarm.

Stomach Tube

The tube passes through your nose or mouth and into your stomach. The drugs you receive
during transplant cause your bowels to stop working for a short while. This tube drains your
stomach secretions and prevents you from throwing up. This tube will be removed when the
breathing tube is removed.

Visiting

It is important that family members talk with the nurse before visiting. Patients will receive
frequent monitoring and treatment. The nurse will help address the family’s needs without
creating confusion or stress for the patient. Sick family members (even just a cold) should not
visit. All visitors must wash their hands very well before going into the room. Children are
allowed to visit on a case by case basis. Please talk with the nurse before bringing a child to
visit.

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Flowers

Transplant patients are not able to have flowers or living plants in their room. These can carry
germs that can cause infections in new transplant patients. Balloons are a nice alternative to
flowers.

The next picture shows your room as it will appear right after transplant. This picture is only a
model. Your surgery may be more complex. If you or your family have any questions, please
feel free to ask the staff.


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In the Operating Room

Family may stay with you until you are taken to the operating room
(OR). Once you are in the OR, an OR nurse will answer questions,
make sure you are comfortable, and explain what is happening.

While you are in the OR, there will be ECG (electrocardiogram)
patches on your chest, a blood pressure cuff on your arm, and a
plastic clip on your finger to check your heartbeat and oxygen levels.
The anesthesiologist will ask you to breathe oxygen through a soft
plastic mask and medicines will be given through your IV. After you
are asleep, a breathing tube (endotracheal or ET tube) will be placed
into your trachea (windpipe) to breathe for you. Other lines and monitors will be added after you
are asleep.
A Note to Families

For most surgeries, patients are away from you for 6-8 hours. During this time, you may wish to
wait in the surgery waiting area. Feel free to bring along a book or something to do since the
time may seem to pass slowly. If you wish to leave the waiting area, please sign out/in at the
nurses’ station. The cardiothoracic nurses will keep you informed during surgery. After surgery,
the surgeon will talk with you.

◙ Medicines
Key points to keep in mind

ξ Choose one drug store to fill your prescriptions. This permits the pharmacist to keep a
complete record of your drugs. It also helps them to better watch for drug interactions
and adverse effects. This will make it easier to ensure that your drugs are in stock and
ready for you each month.

ξ Store your drugs at room temperature unless told otherwise by your coordinator or
pharmacist. Keep them out of light and away from moisture. Do not store medicine in
the bathroom.

ξ Keep your drugs in their original bottles, tightly closed, and all in one location. Keep all
drugs away from children and pets.

ξ Do not share your medicine with others. Do not take anyone else’s medicine.

ξ If you miss a dose of your medicine, take the missed dose as soon as you can. Then,
resume your normal dosing schedule. If it almost time for the next dose, skip the missed
dose and return to your regular schedule. Never take a double dose or extra doses.

ξ Be careful not to run out of your drugs. Refill your prescriptions before you start running
too low. Plan ahead for weekends, holidays, and vacations.

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ξ Take all the medicines prescribed by your doctor. Keep a list of all your medicines with
you.

ξ Take your transplant medicines at the same time each day. (Going to twice daily
medication administration)

ξ Talk with your transplant coordinator and your pharmacist if you or your local doctor
recommends or prescribes a new drug (prescription, natural product, supplement,
vitamin, over-the-counter). They can ensure there will be no interactions with your
transplant drugs and the new drug.

ξ Wear a medical alert bracelet indicating you are a transplant recipient. In case of an
emergency, this would tell health care workers that you take immunosuppression
medications.

ξ Never increase or decrease a medication dose without being told to do so.

ξ Your doctor will want to watch how you are doing on your drugs. It is vital to keep all
follow-up visits for check-ups and blood tests.

o On the days that you have blood tests scheduled, do not take your medicines until
after you have your blood drawn at the lab. You should go to the lab for the
blood draw at about the time that you would take your morning medicines.

ξ Call 911 if you ever have signs of a life-threatening reaction such as
o Difficulty breathing.
o Coughing up bright red blood.
o Swelling of the face, lips, tongue, or throat.


A medicine class will be held to help you learn more about your medicines. Also, a pharmacist
will meet with you and your support person to help you learn to manage your medicines,
including how and when to take them.

Medication Checklist

Dose


























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Dose


























◙ Vital Signs

ξ How often do I need to check my vital signs?
ξ When do I need to call my coordinator?

Vital signs are key in keeping an eye on your health and new lung(s). Any changes in your vital
signs can alert you and the transplant team to problems that may need to be looked at. About 4-5
days after your transplant, your nurse will:
ξ Show you how to do your vital signs.
ξ Help you practice taking your vital signs.
ξ Watch you take your vital signs and record them in your log book.

Check your temperature, blood pressure, and pulse rate twice a day. You may be asked to do
this more often if we are making changes to any of your medicines. Most people do their vital
signs before getting out of bed in the morning and before the evening meal or before bed. You
will also need to weigh yourself at the same time each morning. You will work with your
transplant team to set up a plan and a time that you should check your vital signs. Be sure to
write down all of your vital signs in your log book. Bring this log book to all of your clinic
visits. This is very useful to the transplant team. It helps them to see how you are doing and to
make any needed medicine changes.

ξ Blood Pressure
This can be higher in the early morning, which is why you will need to take it before
getting up out of bed. Be sure to look at upward or downward trends. Call your
coordinator if your blood pressure is greater than 150/90 or if you feel dizzy or
lightheaded.
ξ Temperature
Call your transplant coordinator if you have a fever above 100 θ F. Do not take Tylenol ,
ibuprofen, or aspirin before talking to your coordinator. These drugs lower fevers. They
may mask symptoms of infection or
rejection.

ξ Pulse
Take your pulse for one full minute or
use blood pressure cuff.

ξ Weight
Weigh yourself after going to the
bathroom in the morning. You will
need to learn what your normal weight is. It is vital to watch for a sudden weight gain.
This may mean you are holding onto fluid. You will also need to watch for a decrease in
your normal weight. Call if you have a weight gain of more than 3-5 pounds in 1-2 days.



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◙ Diabetes

ξ What can cause this?
ξ What will be done if my levels are high?

High blood glucose levels can occur if you start to take certain drugs like steroids. Even though
your body still makes insulin, these drugs prevent insulin from working well enough to keep
blood glucose levels normal. Drugs that may raise blood glucose levels are

ξ Cyclosporine
ξ Tacrolimus
ξ Prednisone or dexamethasone

Normal blood glucose levels are 70 – 100 mg/dL when fasting and before meals. The normal
levels after meals are 70 – 140 mg/dL. Keeping blood glucose levels as normal as possible will
promote healing. Also, there is less chance for problems like rejection and infection. You might
feel better and have more energy when blood glucose levels are normal.

Some people have high blood glucose levels only when taking these drugs. Others may still
need to check blood glucose levels after the drugs are stopped. If you are taking medicines to
lower your blood glucose level, it will important for you to have a local resource, like a diabetes
teaching nurse or an endocrinologist to help you check these.

◙ Basic Lab Values

ξ How often do I need to have lab work drawn?
ξ Why do I need to have lab work drawn for the rest of my life?
ξ What are the labs drawn?

The immunosuppressive drugs that you take for the rest of your life after transplant require that
certain labs be drawn. These will need to be done on a routine basis right after transplant and at
least 4 times a year after that. These can be drawn at your local clinic or doctor’s office. Having
these labs done is vital to your safety and long term health. They are done to check for:
ξ Infection
ξ Drug side-effects
ξ High cholesterol
ξ Lipids
ξ Other organ function

Complete Blood Count (CBC)
This test checks for infection and anemia. It is not unusual for lung transplant recipients to have
borderline abnormalities in their white blood count (WBC), hematocrit, and platelet count.



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Creatinine/BUN
These are test of your kidney function. This may also be done before x-ray tests that require the
injection of intravenous dye.

Potassium, Electrolytes, and Magnesium
These are done to ensure that certain drugs have not lowered the body’s store of these needed
elements. If your levels come back low, supplements may be needed.

Cholesterol, triglycerides, and lipid panel (LDL)
These tests are done to assess your risk of developing heart disease, stroke, and other circulatory
problems. These values may be increased by your immunosuppressive drugs. Over time, high
levels of these can affect your blood vessels and your transplanted organ. Eating a heart-healthy
diet and getting regular exercise can help to keep these levels in control. You must fast for 12
hours before these tests are drawn. Ideal lab values for transplant patients are:
ξ Cholesterol – less than 200 mg/dl
ξ Triglycerides – less than 100mg/dl
ξ LDL (the bad cholesterol) – less than 100mg/dl
ξ HDL (the good cholesterol) – higher than 40mg/dl

Liver function tests: AST, ALT, Bilirubin, alkaline phosphate, LDH
These tests are used to check for drug side effects and other disease processes. A minor rise in
these is common. Serious problems will cause a rise of at least twice the normal range.

CMV DNA Capture
This test is used to see if you have active cytomegalovirus. This is a virus in the herpes family
that is common in transplant patients. This test is done any time we think you may have the
virus in your system.


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◙ Biopsy Results

ξ What is a biopsy?
ξ Why are biopsies done?
ξ When will I have a biopsy?
ξ What happens if a biopsy shows rejection?

Biopsies are done at regularly scheduled intervals after your transplant:
ξ 1 week
ξ 6 weeks
ξ 3, 6, 9, and 12 months

The transplant team will decide on your bronchoscopy/biopsy schedule. More biopsies may be
required if rejection is suspected.

The biopsy procedure is done using a tiny forceps passed through a channel of the bronchoscope
into your lungs. You will be told to breathe out slowly as the pulmonologist obtains a small
sample of lung tissue. This step is most often repeated until a number of tissue samples have
been obtained for analysis. Sometimes, real-time chest x-rays (fluoroscopy) are used during the
bronchoscopy to help direct the forceps to the desired site in the lung. Based on these findings
your biopsy is graded from 0 to 4. Biopsy results are not impacted by the person doing the test
or the technique used. Pathologists use an internationally recognized standard for evaluating and
grading the biopsy. Your lung transplant team will call you with results.

A biopsy of proven rejection often requires treatment. This may include high dose (IV) steroid
therapy in the hospital. You may be treated at home with a high dose of oral prednisone and/or
an increase in your other immunosuppression medicines. Another biopsy will be done 4-6 weeks
later to see if the treatment worked.

◙ Rejection

ξ What is rejection?
ξ When can this occur?
ξ What are the signs of rejection?
ξ What should I do if I have signs of rejection?

The risk of rejection is greatest the first 6 – 12 months after transplant. It is common to have a
rejection. This is the body’s normal immune response to “foreign” tissue.

Your immune system is a special group of cells that protect your body from foreign invaders.
When you have an infection, these cells search out and destroy the germs. Unfortunately, these
cells view your transplanted lung as foreign. This is called rejection. Without immunopressive
drugs these cells would harm your transplanted organ. You need some immune system function
to stay healthy. These drugs do not fully eliminate your immune system.

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There are two types of rejection:
ξ Acute
ξ Chronic

Chronic rejection most often happens more than one year after transplant. We watch for signs of
chronic rejection.

Acute rejection is the most common type of rejection. This occurs at random times after
transplant. It is found and confirmed by a bronchoscopy.

Most people with lung transplants have rejection episodes. You are most vulnerable to this in
the first three months after transplant. The chances of rejection begin to drop after the first three
months and then decrease sharply after that. Despite this, you are always at risk for rejection.
The best thing you can do to prevent this is to take your medicines exactly as ordered.

Rejection may cause your lung(s) to work less efficiently. This can produce symptoms. These
are often the same symptoms of advanced lung disease that you had before the transplant. With
the use of medicines we can reduce the immune system activity and reverse the rejection. These
drugs have side effects that can cause new health concerns. High blood pressure, high
cholesterol, diabetes, and osteoporosis can occur. Most of these side effects can be treated. Diet,
exercise, and how well you follow your treatment plan all affect how you will be able to manage
the side effects.

It is vital to be aware of the signs and symptoms of rejection. Call your transplant coordinator
right away if you have
ξ Shortness of breath
ξ Feeling more tired than usual
ξ 10% decrease in spirometry
ξ Increase coughing
ξ Change in sputum color to yellow, green or bright red.
ξ Sudden rise or drop in blood pressure
ξ Lightheaded or dizzy feeling
ξ Low-grade fever (100° F)

Do not ignore these symptoms. Call your transplant coordinator to discuss your concerns.
Timely diagnosis and treatment of rejection is critical in protecting your transplanted lung(s).

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◙ Pulmonary Rehabilitation

ξ Why do I need this?
ξ What will this consist of?

The goal of pulmonary rehabilitation, after your lung transplant, is to make sure you do not
become weak. A quick start is vital! You will begin exercises very soon after transplant. This
will
ξ Increase your strength.
ξ Reduce your risk of pneumonia.
ξ Reduce your risk of developing blood clots in your legs.
ξ Shorten your length of stay in the hospital.

A member of the rehab team will visit you the day after your transplant. Your sessions will
begin by the rehab staff checking your blood pressure while you are seated and standing. Your
heart rate and heart rhythm will be watched throughout the whole session. You will start by
taking short walks. These will increase in time and distance as you get stronger. Day 2 through
the day of discharge may also include seated biking or treadmill walking. Our goal is to have
you perform upwards of 30 minutes of activity each day before you go home. Keep in mind,
each person will recover at a different rate. Your plan will be made to suit you and your specific
needs.

◙ Activity

ξ Why is this important?
ξ What will being active help me to do?

Over time, most patients are able to resume their normal routines. It will take some time to gain
strength and endurance. Keeping up with an exercise routine once you’ve finished rehab is the
best way to manage your weight and improve your well-being.

◙ Incision Care

ξ What will I need to do to care for my incision when I go home?
ξ What do I need to do to protect my incision?

Your rejection drugs can cause wounds or sores to take longer to heal. Your incision may take
1-2 months to fully heal. The staples may stay in place for more than three weeks.

It is OK to shower once your staples are taken out. Use a washcloth with mild soap and water to
gently clean the incision. Do not rub over the area. Do not put any creams, ointments, or
powders on the site. You do not need to cover your incision unless it is draining.

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As your wound heals, you may notice some redness, soreness, numbness, and itching. This is
normal. Call your coordinator for any increase in swelling, tenderness, redness, or drainage.
These are signs of infection.

Your medicines make you more at risk for sunburn and skin cancer. Protect your skin from the
sun by using a sunscreen of SPF 30 & a hat.

◙ Infection

ξ When and who should I call if I think I have an infection?
ξ What can I do to prevent infection?
ξ When do I have to wear a mask?

The anti-rejection drugs you will take after transplant place you at risk for infection. You will
need to watch for signs and symptoms of infection. These would include

ξ Redness
ξ Increased cough
ξ Decrease in spirometry
ξ Swelling
ξ Pain
ξ Fever – Please call with any temperature greater than 100° F. Do not take any drugs for
fever unless told to by your coordinator or doctor.
ξ Fatigue
ξ Odd colored drainage (For example – yellow or green sputum or sinus secretions, cloudy
urine, cloudy wound drainage)
ξ Rash There are four types of rashes to watch for:
Ρ Steroid rash – This looks like pimples or acne. Common on the face, chest, and
back where skin is more likely to be oily. Treatment is good hygiene and may
include medicine for acne.
Ρ Yeast infection – This is a red raised rash with a burning and itching feeling. It is
common in the groin area (jock itch), on the feet (athlete’s foot), under the breast, in
the under arm region, or between any folds of skin. Antifungal cream or powder is
the common treatment. You can prevent this with good hygiene and by wearing
loose breathable clothing.
Ρ Shingles – This looks like a fluid filled raised rash. It will be clustered in places such
as the shoulder, face, back, or leg. This is caused by a herpes virus and can be very
painful. It is treated and prevented with antiviral medicines such as acyclovir or
valacyclovir. This is caused by the same virus as chicken pox. You should stay away
from anyone who has active chicken pox.
Ρ Hives – This is an allergic reaction. With this you will see large raised lumps. These
can be very itchy. Treatment is based on the cause and how severe the reaction.

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You are always at risk for infection. There are things you can do to help prevent this:

ξ Good hygiene – Wash your hands after using rest rooms, before you eat, before you put
on make-up or insert contacts, before and during food preparation. Using anti-bacterial
hand gel is also a good choice. If you are not in a long-term monogamous relationship,
you should always use latex condoms during sexual contact. The condoms will reduce
your exposure to CMV, hepatitis B and C, HIV, HSV and other sexually transmitted
diseases.
ξ Wear a Mask – You need to wear a spore filter mask (blue duck bill mask when:
o You are in hospitals, clinics and laboratory areas. These places are often under
construction and they have other ill patients. You may have your mask off if you are
in a private room and the room is hepa-filtered.
o You are working in dusty environments or working with soil or mulch. Gardening,
yard work, farming or working in a barn, construction type work, cleaning very dusty
rooms such as basements, attics, or garages all require you to wear a mask.
o You are flying. Airplanes use re-circulated air during flights. Anyone on the plane
who is ill may be passing it on through the air.
o You are in a large crowd in poorly ventilated areas. You do not need to wear a mask
if there is good air circulation—such as at concerts, church, movies, or outdoor
activities.
ξ Gloves - Wear proper work gloves when working with dirty engines, in barns, in soil,
mulch, or doing yard work. If you fish, use a gripper glove. This will prevent you from
having direct contact with the slime and scales. These can carry bacteria.
ξ Plants and flowers - Fresh cut bouquets can form mold in the standing water. You can
enjoy being in or around flower gardens. It is okay to have potted plants at home. If they
need re-potting or you are bringing in new plants, please have someone else pot them.
This should be done outside with good potting soil before bringing them inside your
home. New plants from the florist or garden center are mixed with vermiculite. This
holds lots of water and the plants can have higher amounts of mold. This also holds true
for seasonal plants such as Easter lilies and poinsettias. If you want to have these live
plants you will need to have them repotted.
ξ Pets: Many families enjoy having pets. You should follow these guidelines.
o Have all pets seen by a vet before bringing them into your home.
o Do not change litter boxes or bird cages. The waste can increase risk of infections.
o Make sure your pets have regular check ups and get all of their vaccines.
o Wash your hands after petting or playing with any pet.
ξ Travel Safety – Travel to developing or third-world countries poses a major risk for you.
This is very true during times when you are at your highest level of immunosuppression.
You should discuss your travel plans with your doctor at least 2 months before you plan
to leave. You must follow your standard safety precautions while you travel. It is a good
idea to get the travel advisory for your country from the CDC website www.cdc.gov.
You should make sure that your vaccinations are up-to-date. Follow the guidelines you
have been given for these. Keep in mind, you should not have live virus vaccines.
Routine vaccinations may not always be effective.
ξ Water Safety – Transplant patients should not drink water directly from lakes or rivers.
There is a risk of cryptosporidiosis, giardiasis, and bacterial pathogens. Infection might
also occur from swallowing water while swimming in lakes, rivers or pools, or going on
water rides at amusement parks.



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CMV

One type of infection that may occur is CMV (Cytomegalovirus). This is a type of herpes virus
that is common in 50-80% of the population. It is often found in the lungs. It can also be found
in the eyes, liver, and stomach. CMV is treated with an antiviral drug. Many patients will
receive a medicine to prevent CMV infection. This medicine can also be used at higher doses if
a transplant patient gets CMV infection.

Thrush

Oral candidiasis (thrush)is a fungus infection. It causes white lesions on the tongue and mouth.
Your throat may also be red and sore. You may find that things taste differently. If thrush does
occur, call your coordinator. Proper mouth care may help to prevent this.

Vaccines: Annual influenza vaccine is recommended for all transplant patients and their
household contacts, including children. Other vaccines may be recommended by your transplant
team.

◙ Medical Alert Bracelet

ξ Why is this needed?
ξ Where do I get one?
ξ What information should be on this?

You should buy some type of medical identification jewelry. This is needed in case you are
found during a medical emergency and are not able to talk. This will ensure that UWHC can be
called right away to guide those caring for you.

Suggested Wording (5 line, 20 character per line limit):

Lung Transplant
(608)263-6400

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American Medical Identifications
ξ 1-800-363-5985 or www.americanmedical-id.com
ξ Access to your complete medical information 24 hrs/day
ξ Bracelets and necklaces



If you choose to use the Medic Alert brand, please note that they will not engrave our direct
phone number on the item. Rather, they will engrave their phone number and charge a yearly fee
to keep your information and the hospital’s phone number on file.

Other options may be available at your local pharmacy.

◙ Appointment with Local Medical Doctor

ξ When do I need to see my local doctor after transplant?
ξ What do I need to call my local doctor for after transplant?

You must have a local doctor to follow your care. Plan to see your local MD shortly after your
transplant. We rely on the local doctor to address routine health issues such as blood pressure,
diabetes, and minor infections. We’ll work closely with your doctor to give you the best care.
The Transplant Team will manage your transplant medicines and address any issues about your
lung. Before starting any new medicines, it is important for you to contact your lung transplant
coordinator. You will need to follow the advice of your local doctor and the transplant team in
regards to diet, exercise, and other health needs. We want you to live a normal, healthy life after
transplant.

◙ Commitment to follow-up care

ξ What things do I need to do after my transplant?
ξ What support will I need from family and friends to meet these commitments?

Keeping the commitment

For a transplant to be a success, you need to commit to:
ξ Follow the treatment plan prescribed by your doctors.
ξ Call your nurse transplant coordinator about any problems and/or symptoms.
ξ Take all prescription drugs as prescribed.
ξ Follow the diet and exercise plan advised by your doctor.
ξ Keep your appointments, clinic visits, lab draws, and biopsies.
ξ Do not abuse your body by smoking, drinking, or using non-prescribed medicines and
herbals.

You will need close follow up especially during the first year after transplant. You will need
routine transplant follow up for the rest of your life.

19
Important Phone Numbers

Lung Transplant Office 608-265-5658
Toll-free 888-522-2501
(Monday through Friday, 8:00am-4:30pm)
Fax 608-263-0597

G7/105 Transplant Clinic 608-262-.5420
Nursing Staff-B4/5 608-263-8720

Lung Transplant Social Worker 608.890-9209
Patient Housing 608-263-0315
Financial Advisor 608-228-4523

In a medical EMERGENCY, please proceed to the nearest emergency room or call 911.
Always have the ER doctor call the UW Access Center (608) 263-3260.

608-262-0486 is the number for the University Hospital paging operator. When you call this
number be sure to:
1. Call this number after 4:30pm and on weekends and holidays for emergencies
only.
2. Tell the operator you are a lung transplant patient.
3. Ask for the cardio-pulmonary transplant coordinator on call.
4. Give your name and phone number with the area code.

If you do not hear from someone in 20 minutes, call back.

To reach your coordinator for questions, prescription refills or other problems, please call
608-265-5658 and ask for your coordinator by name Monday through Friday, 8am-4:30pm.
Please reserve the “after business hours” calls for urgent calls only. Prescriptions will only be
filled during business hours, so please watch your medicines carefully.









Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2017. University of Wisconsin Hospital
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6686