After Heart Transplant

How should I recover after a heart transplant?

After your heart transplant surgery, there are certain steps you’ll need to take in order to recover well, live a fulfilling life, and stay healthy and out of hospital. Following your heart transplant program is one of these steps.

Your heart transplant program is a detailed program which includes taking daily medicines, maintaining a healthy, active lifestyle, having regular tests, going to transplant clinic appointments and attending your transplant rehabilitation program. Your transplant team will give you personalised instructions on what’s involved in all of these steps, so you can feel confident you know exactly what needs to be done. 

To find out more about your heart transplant, you can watch a talk from our transplant nurse consultant in this video.

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It’s very common to feel ‘different’ after your heart transplant surgery. To hear from our clinical psychologist  about some of the emotional changes you may experience during your recovery, watch this short video.

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What should I eat after a heart transplant?

A healthy diet full of fresh fruits, vegetables and whole grains will help to keep your new heart healthy - and it will also reduce your risk of complications and further heart disease. There are many lifestyle factors that can increase your risk of heart disease, including high blood pressure, high cholesterol, poorly controlled diabetes and being overweight or obese. 

Some of the medications you’ll be given after your transplant surgery can put you at a greater risk of experience these factors - for example, the medication called prednisolone can make it harder for you to maintain a healthy weight. Despite this, your diet is an important part of your lifestyle that can have a positive influence on these risk factors.

When it comes to preparing food, you’ll need to be extra careful in the kitchen. While your medications stop your body from rejecting your new heart, they also reduce your immune system - and as a result of taking them, you could be more likely to experience food poisoning. So always remember to handle and store food safely and take care when eating out.

Avoid high risk foods such as raw or undercooked seafood, poultry and eggs. Ideally, your healthy diet should include:

  • Meat - and/or meat alternatives such as eggs, tofu, legumes and nuts 
  • Fish - 2 serves of oily fish per week such as salmon, mackerel or sardines will help you get plenty of heart healthy omega-3 fats 
  • Wholegrains - good wholegrain choices include wholemeal or wholegrain bread or crackers, brown rice, wholemeal pasta, quinoa, freekah, barley, rye, rolled oats, polenta and couscous
  • Dairy - preferably low fat 
  • Healthy fats - a small amount of healthy fats and oils from nuts, seeds, avocado and oily fish
  • Water - avoid sugary soft drinks and drink alcohol only in moderation 

Aim to consume 2 serves of fruit, 5 serves of vegetables and 4 or more serves of wholegrains - depending on your energy needs. Some other tips to help you eat well include

  • Reduce your salt intake - use as little salt as possible when cooking as this will help to lower your blood pressure and help prevent fluid retention
  • Avoid sugary foods - these are often eaten in place of healthy foods and can contribute to weight gain

You can hear tips from our dietitians about healthy eating after heart transplant in this video.

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What medications will I need to take after a heart transplant?

After your heart transplant, you will need to take medicine for the rest of your life. The medicine helps to stop your immune system from fighting against your new heart. Your immune system views the tissue from your transplanted heart as ‘foreign’, and as a result, it tries to attack your new heart.

The medications you’re given will stop your immune system from fighting against your new heart. They’re called immunosuppressants, or anti-rejection medications. The scientific names of the three most commonly used anti-rejection medications are: 

  • Tacrolimus
  • Mycophenolate mofetil, and 
  • Prednisolone.

You’ll be given these medications when you’re recovering in hospital - and we recommend that you continue taking the same brand after you leave. It’s very important to take your medicine regularly - even if you’re feeling well. 

You should also be aware that all medicines can cause side effects – which are unwanted signs and symptoms that you can experience when you take your medicine. There are steps you can take to reduce these, and your doctor is the best person to ask about this. 

Always use your medications as directed, and if you have any questions or concerns, or if symptoms persist, speak to your transplant doctor. To learn more about heart transplant medications, watch this video from our transplant pharmacist.

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You can also read the Heart Transplant Patient Treatment book to find further information about heart transplant medications.

How do I reduce my risk of further problems after a heart transplant? 

The most important risks after your heart transplant are rejection and infections. To reduce the risk of rejection and infection, take your medications exactly as prescribed, live an active and healthy lifestyle, and attend your medical appointments regularly.

Early detection, as well as understanding the signs and symptoms or rejection and infection, can save your life - so it’s vital that you’re aware of what these signs and symptoms can look and feel like. Some of the symptoms that your body may produce if you’re experiencing an episode of rejection include:

  • Swollen ankles
  • Shortness of breath
  • Weight gain
  • Feeling light headed or dizzy
  • Heart palpitations
  • Tiredness and fatigue
  • Feeling less tolerant to exercise, and
  • Loss of appetite

If you are experiencing any of these symptoms, your transplant team will diagnose that this is definitely rejection by conducting a cardiac biopsy.

Having had a heart transplant, you’re at a greater risk of infection because of the medication you need to take. The same medication that stops your immune system from attacking your heart also suppresses your immune system from working as well as it normally does. 

This means you could be at a higher risk than normal for infections like pneumonia, certain viruses such as cold and flu, and other types of infections. Your transplant team will explain these to you in detail. Some of the common signs and symptoms of infection include:

  • Fevers
  • High temperature
  • Cough
  • Sore throat; 
  • Runny nose
  • Fatigue
  • Nausea/vomiting
  • Diarrhoea    

If you have any of these symptoms, your transplant team can diagnose potential infection through blood tests, chest X-rays, CT scans and urine samples, among other types of tests.

Your infection can be treated with oral and intravenous antibiotics, and other forms of medications - depending on the specific infection. 
Many of the steps you need to take to avoid infections are simple, everyday things you can do, like washing your hands and maintaining good personal and dental hygiene, covering any cuts and wounds, staying away from people who are sick - and in particular, avoiding children with illnesses - and keeping pets clean. 

You can also find out more about infection and rejection after a heart transplant, in this video.

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How do I start exercising again after a heart transplant?

As you’ve probably been told already, there are many benefits to living an active, healthy lifestyle after your heart transplant. Exercise will help to reduce some of the side effects of the medications you’ll be taking - particularly the steroid medications. Another benefit of regular exercise is that it helps to keep your blood pressure, cholesterol and weight healthy - these are very important points, given your recent heart surgery. 

Exercising also helps you to sleep better and feel better. It gets you outdoors, out of the house and can really lift your mood when you’re feeling down or sluggish. 

As you exercise more and more, you’ll notice improved strength, flexibility and coordination - which means simple things like lifting and climbing stairs will become easier, and you’ll be able to do more without feeling tired or puffed - and as a result, your quality of life will be drastically improved.

After being discharged from St Vincent’s Hospital following a heart transplant, you’ll attend an exercise class two times a week for several weeks.  In these classes, you’ll be given a personalised exercise program - and, you’ll be guided on appropriate exercises for your stage of recovery. You will also be given an exercise program you can do at home. This will include simple exercises and movements that are low risk and designed to ease you back into exercise.

When you’re recovering from a heart transplant, or if you haven’t exercised for some time, you will need to start slowly and lightly - meaning you’ll be building up towards the recommendation of 30 minutes per day.  

You can hear from our transplant physiotherapist about how to start exercising after your heart transplant in this short video.

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Where can I go for ongoing support after a heart transplant?

After you leave hospital, your transplant team will be available for ongoing support as you recover. Your transplant rehab program includes group support with other patients like you who have experienced similar surgery. 

You can also contact the following organisations for support and advice:

Remember, a heart transplant can improve the quality of your life and, in many cases, save your life when all other procedures haven’t helped. By following your transplant program, taking care to prevent infections and monitoring your own health, you can continue to live a healthy, fulfilling life for many years to come.

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