​​​​​​Where do I go after my surgery?

After your transplant surgery, you will first go to the intensive care unit (ICU). The ICU team will care for you. How much time you spend in the ICU is different for everyone. Once you are stable and your breathing tube has been removed, you will be sent to an inpatient unit. You will be weak after your surgery, but you will slowly resume an active role in caring for yourself.

What can I do in the hospital after my surgery to help with my recovery?

To help you recover:

• Follow the instructions of your healthcare team.
• Ask for medicines when you are in pain.
• Practice deep breathing and coughing techniques.
• Change positions in bed and keep moving your arms and legs.

When will I be able to leave the hospital after my transplant?

You will leave the hospital when:

• You have learned how to take your own medicines.
• You are able to recognize the signs of infection and rejection.
• You are able to care for your ileostomy.
• You are physically stable.

What happens after I leave the hospital?

It is important to know that getting an intestinal transplant means a lifetime commitment to medical treatments.

After you leave the hospital:

• Your transplant team will follow you closely. Your follow-up appointments and tests may take up a lot of time and you will need to take time off work. Make sure you have a way to get to and from your appointments.
• You will need to visit the clinic at least once a week for the first month after your transplant. After that month, how often you visit the clinic depends on your medical needs.
• You will go for lab tests at least 2 times each week for the first month after your transplant. After 1 month, you may not need to have lab tests as often. Having lab tests is how your transplant team knows if the transplant is working and if you are taking the right amount of medicines to prevent your body from rejecting the organ or organs (anti-rejection medicines).

To help with your recovery and overall health:

• Eat a balanced diet and maintain a healthy weight.
• Exercise regularly. Be sure to follow the guidelines your therapists and doctors give you.
• Do not drink alcohol.
• Do not smoke.
• When travelling, always bring enough medicine.
• When going out into the sunshine, wear a hat and sunscreen. Do not get a sunburn. The medicines needed to prevent rejection of your transplant increase the risk of skin cancer. Avoid tanning beds.
• Take good care of your teeth. See a dentist regularly. Before any major work on your teeth or mouth, call your transplant team.
• Sexual activity is allowed as long as it does not cause discomfort and you have talked with your transplant team.
• You will need to keep seeing your family doctor, and any other healthcare providers for your general healthcare needs.
• Tell the transplant team if there are any changes in your medical condition or the medicines you take.

What kinds of medicine will I need to take after my transplant?

Anti-rejection medicines prevent your immune system from destroying the transplanted organ or organs. You will need to take anti-rejection medicines every day, 1 to 2 times each day, for the rest of your life, as long as the transplant is working. Not taking these medicines as instructed, or missing doses, may lead to your transplant not working.

Never stop taking these medicines without talking to a member of the intestinal transplant team first.

When you take anti-rejection medicines:

• Do not get pregnant or get someone pregnant while on anti-rejection medicines without first talking to a member of the transplant team.
• You will need to get bloodwork done often to monitor your medicine levels. This lets the transplant team know if you are taking the right dose for you, and if any changes need to be made.
• Tell your pharmacist, dentist, and all other healthcare providers that you are taking these medicines.
• Many drugs and some foods will interact with your anti-rejection medicines. Avoid these items, such as: grapefruit, anti-inflammatory medicines (like ibuprofen or Advil), herbal supplements, and some antibiotics. Talk to the transplant team or your pharmacist to learn more about which drugs and foods to avoid.
• Anti-rejection medicines can increase your risk of some types of cancer. For more information, talk to the transplant team.

There are other medicines you might need to take, too:

• You will need medicines to protect your stomach from ulcers caused by other medicines.
• You may need antibiotics to help protect you against infection.
• You may be given a fluid pill to help your body remove extra water.
• You may need some medicines to keep up with essential nutrients like potassium, magnesium, or iron.

You are responsible for taking your medicines. You should talk to your doctor, pharmacist, inpatient nurse, or coordinator to understand:

• the name and reason for each medicine
• when to take each medicine
• how to take each medicine
• how long to continue taking each medicine
• side effects of each medicine
• what to do if you forget to take a dose
• when to order more medicine so it doesn’t run out

Your coordinator will teach you about these medicines while you are in the hospital. While there, you will start giving them to yourself, with directions from the nurses. This will help you get used to the new medicines you will need to take at home by yourself.

What is rejection?

Rejection happens when the transplanted organ or organs are destroyed by your own body.

The best way to prevent rejection is to take your anti-rejection medicines on time, take the right dose, and collect lab work as scheduled.

It is very important to watch for any signs of rejection so that your doctor can treat it quickly. Possible signs of rejection may include:

• fever
• abdominal pain
• vomiting
• diarrhea (higher output in your ileostomy)

If rejection happens, you will have an appointment with the transplant team to review your options.

Rejection can happen at any time. This is why intestinal biopsies are done regularly. Biopsies can show the transplant team signs of rejection long before you have symptoms, so treatment can start early.

How can I avoid getting sick after my transplant?

After your transplant, you have a higher chance of getting an infection.

Possible signs of infection include:

• temperature greater than 37.5^oC
• sweating, chills, and shaking
• pain
• redness
• swelling
• change in colour, amount, and smell (odour) of your urine, stool, or mucus
• shortness of breath
• open sores that have drainage
• burning when you pass urine

Report signs of infection to your transplant coordinator right away during office hours or call Health Link at 811 after hours for advice.

You may be given medicines for a period of time after your transplant to help prevent some of these infections.

It is important to take steps to protect yourself from getting sick, like washing your hands and avoiding contact with people who are sick.