Post-Transplant Wellness
Preventative Care
It's very important to stay healthy after
a transplant and to prevent infections. All transplant
patients need to follow these guidelines:
- See your primary care physician at least
once a year.
- Have a yearly flu shot.
- Avoid contact with anyone who has had a live
vaccination.
- Have your teeth cleaned every 6 months.
- Keep your skin as clean as possible.
- Avoid people with colds and communicable
diseases, such as chicken pox, measles or herpes.
- Avoid exposure to the sun. Wear sunblock
and a hat.
- Women should have a yearly Pap smear and
mammogram.
- Men should have a yearly prostate specific
antigen (PSA) test.
Exercise after Your
Transplant
If you've just received an organ transplant,
you're most likely weak from the illness that
caused the need for the transplant. In addition,
you're recovering from major surgery. As a result,
exercise will be somewhat limited when you initially
return home. You should not lift anything that
weighs more than 15 pounds for at least 2 months.
You'll need to exercise regularly to regain your
strength. Because you may feel tired at first,
you should take rest breaks during exercise. Walking
is an excellent form of exercise when you first
get home. Gradually, increase the amount and type
of physical activity you enjoy. Ask your transplant
physician or nurse before taking on a new sport.
Remember to avoid any activity that could cause
a direct blow to your transplanted organ.
Avoid Weight Gain after
Transplant
The average weight gain after organ transplantation
is between 15 and 35 pounds. Some people need
to regain weight if they were underweight before
transplantation. However, excessive weight gain
often occurs as a result of eating habit changes
after transplantation. In addition, many individuals
experience an increased appetite as a result of
steroid medication.
Excessive weight gain can be harmful to your
health because it increases the risk of heart
disease, vascular disease, diabetes
and osteoporosis.
To avoid excessive weight gain:
- Be smart when food shopping. Choose low-fat
dairy products made from 1% or skim milk, and
lean meats, such as canned tuna packed in water,
chicken breast, turkey breast or extra lean
ground beef. Buy more fresh vegetables and include
them with meals at least twice a day. Also try
selecting healthier condiments, such as mustard,
"lite" mayonnaise, "lite"
salad dressing or tub margarine.
- Choose healthy cooking methods. Bake, grill,
broil or boil foods. Avoid frying. Use nonstick,
fat-free spray, fat-free sauces or unsaturated
oil (substitute 1 tablespoon of olive or canola
oil for butter).
- Avoid overeating. Curb your appetite by drinking
more water (about 8 to 10 glasses a day). Try
to eat high-fiber foods, such as raw vegetables
and fruits, which make you feel full.
- Be cautious when dining out. Most restaurants
serve large portions, so save half for later.
Avoid high-fat entrees, such as prime rib, chicken
wings or fried fish. Choose grilled chicken
breast, grilled and baked fish, or veggie burgers
instead. Stay away from entrees cooked in high-fat
cream sauces, and instead choose marinara sauces.
Also, limit high-calorie condiments by asking
for salad dressing or mayonnaise on the side.
Diet after Transplant
After your liver transplant, you will be feeling
better and looking forward to returning to your
normal lifestyle. A major part of that normal
lifestyle is the ability to enjoy eating again.
However, Prednisone®, a steroid that decreases
your body's natural tendency to reject your new
organ, affects the way in which your body processes
food.
Everyone who receives a transplanted organ will
take Prednisone®. You'll notice that your
appetite may increase quite a bit while you take
Prednisone®, and you'll be likely to gain
weight, putting on both pounds and inches.
Prior to your discharge from the hospital, a
dietitian will talk to you about your dietary
goals and requirements. You may gain less facial
and body fat if you follow a low-fat, low-calorie
diet. However, each person is different, and the
dietitan will recommend meal plans that might
work for you.
Prednisone tends to decrease calcium absorption
and increase the risk of osteoporosis. Therefore,
you should add more calcium to your diet, in the
form of calcium-rich foods such as low-fat dairy
products and green, leafy vegetables.
Generally, people who have received a liver transplant
should eat a balanced diet with plenty of fruits
and vegetables and a minimum amount of salt, processed
foods and snacks. The recommended daily allowances
include:
- 2 to 3 servings of milk, yogurt or cheese
- 2 to 3 servings of meat, poultry, fish, dry
beans, eggs or nuts
- 3 to 5 servings of vegetables
- 2 to 4 servings of fruit
- 6 to 11 servings of bread, cereal, rice and
pasta
Serving sizes are listed on food package nutrition
labels. Eat as little fats, oils and sweets as
possible. Try to watch your food intake and develop
good habits that will help control any weight
you may gain.
You should strive to stay within a normal weight
range and add exercise to your routine as you
feel comfortable doing so.
Don't drink alcohol or use any drugs that aren't
prescribed by your physician, as they may harm
your new organ. If you have a problem with drugs
or alcohol, talk with your social worker, who
can help arrange for counseling and other support
services.
If you have any problems with your diet, or with
weight gain or weight loss after transplant, tell
your transplant coordinator and ask to see a nutritionist
who can recommend changes in your meal plan.
Sex and Reproduction after
Transplant
Many transplant recipients are curious to
know how their sex lives will change after their
transplant. Most transplant recipients return
to normal sexual activity after their sutures
are removed and their incisions have healed.
Practicing safe sex after your transplant is
more important than ever. A woman's menstrual
period usually returns within six months of transplant,
though ovulation often starts sooner, so you need
to use birth control immediately. A condom and
diaphragm, when used properly together, are the
most recommended form of birth control. If your
period is irregular after your transplant, you
should discuss this with your doctor.
Female transplant patients of childbearing age
who want to have children should consult with
their doctor before becoming pregnant. Though
childbirth is often possible, there are serious
health considerations for you and your baby.
Male transplant patients of childbearing age
usually remain fertile. In fact, male liver transplant
recipients who were infertile often become fertile.
Any infection following a transplant is serious.
If your partner has open sores on his or her genitals
or in the mouth, abstain from sex. If you develop
unusual sores or vaginal or penile discharge,
see your doctor.
Some post-transplant medications may impair sexual
function. If you think this may be true in your
case, talk to your doctor or specialist.
Revised by Kim
Olthoff, MD
Last updated February 2006
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