Harvey's Blog

After liver recipients are discharged from the hospital, they have the responsibility for monitoring their health and avoiding rejection. The following guidelines should become a natural way of life for them:

• Always wear a medical bracelet or necklace. It is imperative for emergency health care personnel to know that a person has had a transplant.
• Avoid anyone who has a cold, flu, or does not feel well until that person is free of symptoms.
• Avoid crowds and crowded rooms.
• Stay away from areas under construction or areas where animals live or have lived.
• Make certain any pets are carefully screened by a veterinarian. It is not advisable to have birds as pets, as their waste contains a high level of germs. Do not handle any type of pet waste.
• Keep clean by showering or bathing daily and washing hands with antibacterial soap before meals and after using the bathroom.
• Wash all fresh fruits and vegetables. Molds and fungi may be present on their skins.
• Immediately wash minor cuts and scrapes with soap and water. If they do not heal well, contact the transplant coordinator.
• Report any blisters, sores, suspicious lumps, or growths in the armpits, groin, or elsewhere in the body to the transplant coordinator.
• Check with a member of the transplant team before receiving any type of vaccination.
• Do not smoke!
• Stay away from day care centers, where there may be exposure to childhood infections.
• Discuss any travel plans with the transplant team. Travel in underdeveloped countries is not advised.

Dental care is very important after transplantation and includes brushing teeth after every meal, daily flossing, and gum stimulation. Regular check-ups should be scheduled once a year or as the patient's dentist recommends. Often, preventive antibiotics are prescribed before dental visits to avoid infection. An antibiotic (amoxicillin, or clindamycin for amoxicillin/penicillin allergic patients) is given 1-2 hours before the dental procedure to ensure that there is an adequate level of antibiotic in the blood. The second dose is given 6 hours after the initial dose.

Sexual relations may resume 4-6 weeks after surgery, or as the transplant doctor recommends. Because ovulation in women of child-bearing age may occur before their menstrual cycles regulate, these transplant recipients should use birth control. The barrier methods are the best types of birth control in transplant patients. These include condoms, diaphragms, and sponges, all with spermicides. Intrauterine devices (IUDs) carry a risk of infection, and therefore are not recommended. Oral contraceptives ("the pill") should not be used, as they may affect liver function.

Some men may be interested in taking Viagra (sildenafil). Viagra is not known to interfere with any of the medications commonly taken by transplant patients. However, men taking nitrates for angina or chest pains should not take Viagra-the combination may cause blood pressure to drop to dangerous levels and also arrhythmias (abnormal heart rhythms). Male liver transplant patients should consult a urologist or private physician if they feel that they may need Viagra.

Source: www.theuniversityhospital.com