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Post-Transplant

Responsibilities

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Section 1: Post-TransplantResponsibilities

What are my major post-transplant responsibilities?


1. Medication Administration 2. Body Temperature 3. Blood Pressure 4. Weight




Medication Administration


  • After transplant it is of paramount importance that you take medications as directed.
  • Learn the name of each new medication and why it’s being used.
  • Learn how the medications should be taken (when, how much to give, and how to give).
  • Practice giving the medications while still in the hospital.
  • Learn a good routine while in the hospital, because you will be expected to give all medications as prescribed once you go home.
  • Medication doses may change frequently. Use your printed medication schedule, not the prescription bottles for knowing how much medication to give.
  • Carry your medication list with you at all times.
  • Always have extra anti-rejection medication with you just in case you get stuck somewhere or drop a pill on accident.




Body Temperature


  • Keep a temperature record.
  • Always check your temperature when you wake up first thing in the morning.
  • If you ever feel clammy or have chills/ feel like you have a fever, then check your temperature.
  • In the event you do have a temperature >100.4o F (actual temperatures may vary per transplant center guidelines) call your transplant coordinator.




Blood Pressure


  • Keep a blood pressure (BP) and heart rate (HR) record.
  • You will go home from the hospital with a correctly sized BP monitor. (most transplant centers will provide you with a BP monitor)
  • The blood pressure monitor will also give you a HR when you check BP.
  • Always check your blood pressure first thing in the morning when you wake up and/or as indicated by your transplant team.
  • You may be asked to check your blood pressure prior to taking blood pressure medications to determine if you are within your parameters for taking medications.




Weight


  • You should always take your weight at the same time of day with the same type of clothing.
  • It is best to weigh yourself first thing in the morning right when you have woken up.
  • Record your daily weights and notify your transplant team with any major changes.





Section 3: Additional Resources

Helpful Downloads from Transplant Unwrapped


Sign-Up or Log-In to Access: 1. Vital Sign Log: Printable handout to keep track of vital signs. 2. Input/Output Log: Printable handout to keep track of input/output records. 3. Lab Values: Printable handout to keep track of lab values and provides an explanation of each value.




Transplant Unwrapped: Learn From Others


Learn From Others: Read stories, watch interviews, and listen to audio from numerous members of the intestinal community on a variety of topics. Useful for This Section: Learn from Others- Patient Post-Transplant Reflections




Transplant Unwrapped: Support Programs


Support Programs: Visit the Transplant Unwrapped Support Programs page to get your questions answered, speak with others in similar situations, and feel well-supported during your medical journey.




Page References


References here.





Section 2: Other Responsibilities

Follow-Up Appointments


It is critical to keep all follow-up appointments as scheduled with the transplant team. These appointments are vital in keeping your new intestine functioning properly and allow you to ask questions regarding your recovery process. At first, you will likely be seen twice weekly for follow-up appointments and the frequency will decrease as you become more stable (this will vary by transplant program, and by patient depending upon how well you are doing). At the appointment, symptoms will be reviewed, input and output records will be reviewed, and nutritional and hydration status will be monitored. You may have appointments with other departments, such as infectious disease, to monitor their health status. These are just as important to keep as the appointments with the transplant team.




Lab Work


Lab work will be done twice weekly immediately after discharge, and then frequency will decrease as you become more stable (once again this will be on a patient-by-patient basis, but this is the general rule). Do not take anti-rejection medications the morning of bloodwork until after the blood has been drawn, this allows for the trough (bottom) level of the medication to be monitored. If your bloodwork is abnormal, you may be called to either adjust the medication dose or to come in to be admitted.




Ileoscopy


Once discharged, you will have an ileoscopy (biopsy/ or scope) of the new intestine every 7-10 days until you are more stable and are not showing signs of rejection (may vary per transplant center and patient. Please note: Every transplant center is different and will have its specific protocols. Some centers may choose only to complete biopsies when a patient shows signs or symptoms of rejection, while others will still do surveillance biopsies regularly. It is best to talk with your transplant team to determine the plan for your care.




How long do we need to stay in my transplant center area after my transplant?


Most transplant centers require you to stay in the area for the first 3-6 months following your transplant (exact time will vary based on your individual needs and the individual center requirements). After that time, your transplant center will determine how often you will need to come back for visits.




When should I call my transplant team?


When to Call Your Transplant Team It is very important to notify your transplant team if you are feeling unwell as this may be a sign of rejection, infection, or another illness that may lead to significant harm. The list below contains recommendations of when to call your transplant team, but is not an all-inclusive list, and you should always refer to your respective transplant center when seeking any medical advice. If you are feeling extremely ill or it is an emergency, proceed to the nearest emergency room or dial 911:

  • Changes in vital signs (blood pressure or heart rate significantly increases or decreases).
  • Fever >100.4o. F (or extremely low temperature <96o F)
  • Difficulty breathing or shortness of breath.
  • Cough, congestion, or runny nose.
  • Increased abdominal pain.
  • Extreme nausea and/or vomiting.
  • Blood in stool, urine, or vomit.
  • Decrease in urine output.
  • Chills or sweats.
  • Sore throat.
  • Significant fatigue out of the ordinary.




When can I contact my donor family and how do I do this?


Sometimes donor families and recipients decide to contact one another. The decision to contact your donor family is entirely your own. To read more, visit our section on post-transplant life.