Why do infections happen after a transplant?

The medicines you take to help prevent rejection work by decreasing your body’s immune system response. Although this helps prevent your body’s immune system from attacking the new organ, it also decreases your immune system’s ability to fight off infection. Fortunately, there are increasingly effective ways to prevent these infections, as well as to treat them when they occur.

You are most vulnerable to illness right after transplant when the level of the immunosuppressive medications are at their highest. However, the risk for infection continues long after you are discharged from the hospital, so it is important to take steps to prevent infection at home.

Call and talk to your transplant coordinator if you notice any signs and symptoms of infection.

What are the signs and symptoms of an infection?

• Fever higher than 100°F (38°C)
• Flu-like symptoms (chills, sweats, aches, headache, or fatigue) or generally feeling “lousy”
• Bloody, cloudy or foul-smelling urine
• Trouble urinating: pain or burning, constant urge or frequent urination
• Nausea, vomiting or diarrhea
• Pain, tenderness, redness or swelling
• Sore throat, scratchy throat or pain when swallowing
• Persistent dry or moist cough that lasts more than two days
• White patches in your mouth or on your tongue
• Sinus drainage, nasal congestion, headaches or tenderness along upper cheekbones
• Skin rash
• Red, warm or draining sore
• Wound or cut that won’t heal

What can I do to prevent infections once I leave the hospital?

• Frequently wash your hands with soap and water, especially before preparing food and after using the bathroom, or after touching soiled linens or clothes.
• Shower daily, using mild soap. Special soap is not needed at home.
• Limit visitors at first. If visitors have cold or flu symptoms, ask them to return when they are feeling better.
• DO NOT go into crowded areas for three months. If you cannot control how far away you are from other people, it is probably a crowd.
• DO NOT let pets lay on your bed and DO NOT pick up after your pets. Enjoy spending time with your pets, but decrease close exposure to them. Have other family members or friends clean the litter box, cage or yard. Wash your hands thoroughly after petting and playing with your pets.
• Exercise daily. Walking helps expand the lungs and strengthen your body. Check with the Transplant Team before doing any advanced exercising such as aerobics and weight lifting.
• Check with the transplant team before visiting with an infant or child.
• Brush your teeth and gums thoroughly after each meal. Use a small, soft toothbrush and fluoride toothpaste. Use foam sticks instead of a toothbrush if your gums are especially sore. Keep dentures clean and fitting properly.
• Use dental floss daily. Contact your Transplant Team if you have red or swollen gums for more than two days.
• Protect your skin from scratches, sores and other irritations that may lead to infection. If you have a cut, clean the area well with soap and water or hydrogen peroxide. Dry your skin and cover the cut with a sterile bandage. If it is a deep cut, go to the Emergency Room.
• Do not use hot tubs, whirlpools, saunas or steam baths. Germs tend to multiply in these environments.
• Be careful in the sun. The medications you take make you more susceptible to the sun’s harmful rays. We recommend that you use sunscreen with an SPF rating of 30 or higher.
• Enjoy the outdoors, but always wear gloves when gardening. Soil has many molds and fungi that can be sources of infection.
• Keep your house clean and free from excess dust.
• Talk to the Transplant Team about when you can safely return to work or school.

What other medical precautions should I take after leaving the hospital?

• Check your neck, armpits and groin area for lumps or new growths. Report signs of these to your doctor.
• Get the flu shot every year. You cannot get the flu from receiving the shot itself. (Flu shots are available at low cost from the Cleveland Clinic or your local health department.)
• Get the pneumonia vaccine if you have not had it.
• See your dentist at least two times per year.
• See your eye doctor at least once a year.
• Women should perform monthly self-breast exams. Women should also have a pelvic exam with Pap smear and a mammogram every year, regardless of age.
• Men should have their PSA (prostate specific antigen) and prostate checked every year.