Life After Your Transplant: Living With Immunosuppression

Living with your transplant: avoiding organ rejection and infection, taking medications

Your body's defenses are always on the prowl for germs and other foreign organisms. Unfortunately, this means that your body is not a very well-mannered host. It treats your life-saving transplanted organ just like it treats a mere freeloading germ. It attacks. Organ rejection is your own body's misguided attempt to protect you.

However, immunosuppressant drugs can block the effects of these natural defenses. They usually allow your body to live in relative harmony with the new organ. The catch is that by blocking your defenses, you become more vulnerable to infections. It's the trade-off of getting a transplant.

"Living with a transplant is always about keeping the balance between rejection and infection," says Barry Friedman, RN, administrative director of the Solid Organ Transplant Program at the Children's Medical Center in Dallas. "You need to take enough of your medicines to prevent organ rejection. But you can't take so much that your risk of infection gets too high."

The good news is that doctors are much more successful at striking a balance these days. No, you won't have to live in a sterile bubble to stay healthy. And after the first few weeks or months, the restrictions on your life really aren't that hard to live with.

"In general, if you have reasonable and healthy habits, you'll be fine," says Jeffrey D. Punch, MD, chief of the Division of Transplantation at the University of Michigan Health System, Ann Arbor.

What Precautions Do I Need to Take After Surgery?

Right after surgery, you're particularly vulnerable. You'll be in the induction phase of immunosuppression. You'll be on pretty high doses; it's key that you take extra care. You should:

• Wash your hands often. Hand washing is an excellent way to reduce your exposure to germs. It's especially important before you eat.
• Avoid people who are sick. It's best to limit your contact with anyone who has a cold or any other infection like measles or chicken pox.
• Avoid people who have been recently vaccinated. Some vaccines, such as the new nasal flu vaccine or the measles vaccine, have a living virus in them. These could be a risk to people with weak immune systems.
• Stay out of crowded areas. For example, avoid malls and movie theaters.
• Don't take care of the pets. Pets carry germs, so limit your exposure to them. You don't have to kick them out of the house. Instead, look at this as an excuse to make your spouse or kids clean out the litter box for a change.
• Don't garden. Some dangerous bacteria live in the soil. So let your garden go wild for a few months. Or make your kids do your weeding for you.
• Brush and floss daily. Both help keep your mouth free of infections. Have your teeth cleaned regularly.
• Don't ignore cuts or scratches. Clean them and put on a bandage. Get in touch with your health care provider if you have any signs of infection.
• Practice verysafe sex. Sexually transmitted diseases like herpes can be a problem for anyone. But they can be dangerous for people who have had a transplant. Condoms may not be enough to fully protect you. Even saliva can expose you to colds and viruses. So be careful. Ask your health care provider about what's safe in your case.

Obviously, specific recommendations depend on your health and situation. Where you live can make a difference. If you're in a city, it's harder to avoid crowds. Living in the country poses different risks, such as exposure to farm animals or potentially unsafe well water, Friedman says. Ask your health care adviser for recommendations.