Living With Immunosuppression After an Organ Transplant

Medically Reviewed by Carmelita Swiner, MD on July 03, 2023
Written by WebMD Editorial Contributors
5 min read

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. That's why there's immunosuppression.

Immunosuppressant drugs can block the effects of these natural defenses. They usually allow your body to live in relative harmony with a donor 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, senior administrative director of AdventHealth Transplant Institute in Orlando, Fla. "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.

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

Right after an organ transplant, 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 exposure to germs. It's especially important before you eat.
  • Avoid people who are sick. It's best to limit contact with anyone who has a cold or any other infection like measles or chickenpox.
  • Stay out of crowded areas. For example, avoid malls and movie theaters.
  • Don't take care of 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 hire someone to do the 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 very safe sex.Sexually transmitted diseases such as herpes can be a problem for anyone. But they can be dangerous for people who have had an organ 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 even 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.

Over the next six months to a year after an organ transplant, your health care team will probably reduce your medication. You'll settle into the "maintenance phase" on a lower dose. At this point, you can usually relax some of your safety measures. You won't be as susceptible to infection. But you should still take precautions. Wash your hands regularly and limit contact with people who are sick or recently vaccinated.

If you ever have an episode where your body rejects a donor organ (organ rejection), your doctor may need to change your medications or boost the dosage of immunosuppressant drugs. Since your immune system will be further suppressed, you'll need to take those extra precautions again.

Your doctor may also occasionally need to change some of the medicines. Some may not work as well over time. New and more effective drugs may also come on the market that will replace old ones.

Living with an organ transplant usually means taking a lot of medication, probably for the rest of your life. Most people take six to 12 different medications daily, Punch says. It could be more. Taking so many pills may sound daunting.

"Some people are overwhelmed by the number of medications they have to take," says Richard Perez, MD, PhD, and the director of the Transplant Center at the University of California Medical Center at Davis. "But you have to remember that a lot of these patients were sick, and already on a complicated medication regimen anyway."

In fact, Perez says, many people find that their drug regimen is less complicated after a transplant.

Taking medication is absolutely crucial to staying healthy. Here are some tips.

  • When it comes to taking organ transplant drugs, strictly follow your health care provider's advice.
  • Use weekly or daily pillboxes to set up doses beforehand, and keep track.
  • Use alarm clocks, timers, or digital watches to help you remember doses.
  • Ask your family members to help you stay on a medication schedule.
  • Keep drugs away from children and pets.
  • Store medication in a cool, dry place.
  • Keep a list of all your drugs somewhere obvious.
  • If you miss a dose, don't assume you can double up with your next one.
  • Keep track of how much medicine you have left. Always call the pharmacy for refills early.
  • If your doctor agrees, take medication with food to prevent gastrointestinal side effects.
  • Set up doses so that they coincide with other daily activities, such as brushing your teeth, eating lunch, or going to bed.
  • Never stop taking a medication without your health care provider's approval.