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What is it about ?
A transplant can be a life-saving medical treatment when an organ in the body is no longer functioning as it should. The most commonly transplanted organs are the kidneys, liver, heart, lungs and pancreas (islets of Langerhans).
A transplant recipient usually stays in the hospital for three to four weeks. After discharge from the hospital, the patient’s state of health, the function of the graft (the new organ) and the concentration of immunosuppressive drugs (which prevent rejection) in the blood are checked regularly.
Most complications occur within a year of the transplant. Medications that prevent rejection then make the patient more vulnerable to viral and bacterial infections, while the medication can mask signs of infection. And even with these drugs, the body can still reject the new organ.
During the first year, the patient is referred to the specialist to detect the slightest sign of possible infection. Good cooperation between the patient, the specialist and the general practitioner is crucial for a quality follow-up throughout life.
What treatments should be started?
To avoid rejection of the transplanted organ, the patient must take immunosuppressive drugs for life. These are drugs that suppress (= slow down) the immune system itself, to reduce the risk of rejection of the “foreign” organ. The first year after the transplant, a low dose of cortisone is also often added to the treatment.
Side effects of this medication may include: increased blood pressure, blood sugar (sugar levels) and fat content in the blood. Medication is also sometimes needed to treat these symptoms. Immunosuppressive drugs also increase the risk of infections, tumors and arteriosclerosis (= calcification of the arteries).
The anticoagulant acetylsalicylic acid (= aspirin) is prescribed to all transplant patients to prevent the formation of thrombosis (clots).
Calcium, vitamin D and sometimes bisphosphonates can counteract bone loss (which may be caused by taking cortisone).
Antivirals may need to be used preventively to prevent the development of cytomegalovirus or herpes virus infection.
Are there any other steps to take?
It is better not to smoke or drink alcohol.
Dental care
It is important to take good care of your teeth. Regular check-ups at the dentist are necessary to prevent infections and monitor any side effects associated with the medication. The patient receives antibiotics as a preventive measure in the event of increased risk interventions.
Vaccinations
Live attenuated vaccines cannot be administered. On the other hand, other vaccines are still recommended: in particular the annual influenza vaccine and that against pneumococci every 5 years.
What happens if we suspect rejection?
If acute rejection is suspected (eg increased liver values after liver transplant), the patient is immediately referred to a specialist for further monitoring. The so-called “chronic” rejection largely explains the failure of the transplant after the first year.
Can you travel as a transplant patient?
Given the risk of complications, it is not recommended to travel abroad during the first six months after the transplant. Then, nothing contraindicates that the transplant patient cannot travel. However, special attention should be paid to hygiene and good sun protection.
It is recommended that the transplant patient have antibiotic treatment with him when traveling. It will be useful in cases of acute traveler’s diarrhea and therefore to ensure that the immunosuppressive drug is sufficiently absorbed by the body.
Before going abroad, ask your doctor for advice, especially with regard to the necessary vaccinations.
Sources
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