Infection
Chronic use of immunosuppressants decreases your resistance to infection. Your level of susceptibility relates to the intensity of the immunosuppression at any given time. These varying levels of immunosuppression may affect where and with whom you are housed when in the hospital.
General guidelines are as follows:
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While in the intensive care unit, you may share a room with an uninfected preoperative and fresh post-operative heart patient or with another transplant patient.
- On the step down units you will be give a private room when available, or housed with uninfected patients i.e., patients who have no fever, no draining wounds, a normal WBC (white blood count) (<15,000) and a clear chest x-ray.
These guidelines will apply for subsequent readmissions, whether routine or emergent. If your WBC falls below 2,000, you will be placed in a private room for protective purposes.
Masks must be worn by employees or visitors in your room if they have a cold, if your WBC is 2,000, and by you if you are out of your room. This precaution is meant to protect you from airborne microorganisms in the hospital.
Masks are not required after discharge except upon return to any hospital setting. You will be susceptible to the common cold or flu viruses but will rarely suffer major complication from them.
We recommend all lung transplant patients and all pediatric patients receive annual flu shots. We have no objection to adult heart patients receiving annual flu shots.
The lung is the most common site of post-transplant infections. To detect early signs of lung infection, frequent chest x-rays are taken in the early post-operative period and then at each clinic visit when you are an outpatient (adults only). You need to be aware of symptoms that could indicate lung infection, such as productive cough, shortness of breath, and temperature elevation.
You should report any of these symptoms promptly to your physician. The ability to heal wounds is decreased in patients taking prednisone. If you injure yourself, clean the area and keep a clean, dry dressing on the wound. Should healing be prolonged and you experience pain, swelling, redness or other signs of infection, notify your physician immediately.
Any sores, blisters, or lumps should be examined and treated by your physician. If necessary, you may be hospitalized for prompt diagnosis and treatment.
Regular dental checkups and hygiene are important, since your teeth and gums can also be sources of major infection. It is recommended that antibiotics be given prior to dental or other manipulative procedure (including dental cleaning) because of the susceptibility of the transplanted heart to infection (endocarditis) with blood-borne bacteria.
The American Heart Association standard antibiotic protocol is recommended for the prevention of infection. Notify your dentist of your need for antibiotics prior to dental care and procedures.