STEP - Support Through Education Program

Step 7: The transplant unit

Our knowledge and understanding of transplantation, illness and recovery has grown over the years through dedicated and organised research. For example, we know that unless patients move very early after an operation, they are at risk of the life-threatening complications of pneumonia and/or clots in the legs and lungs. We also know that hospital are breeding grounds for ‘Super Bugs’ and that extended stays in hospital increase the risk of becoming infected. This can also be life threatening and very costly in terms of expensive drugs and increased length of stay in hospital.

The main goal and work of the staff in the transplant unit in their post- operative cares is to help the new transplant recipient recover quickly from the operation and to learn their medications to enable them to return home as quickly as possible.

The patient arrives in the Transplant Unit, Ward 4BT from as early as day 1 or 2 after transplant - or as late as several months afterwards if there have been complications. The patient’s pre-operative condition, fitness and disease can influence this timeframe. Transfer to the Transplant Unit is the cue to move from the acute to the recovery and rehabilitation phase. The inpatient stay on the Transplant Unit is usually about 7–14 days

The patient can suffer from confusion and hallucinations particularly if they were encephalopathic before their transplant. The medications used in transplantation can occasionally cause confusion and hallucinations which is distressing for both the patient and their family. With the right care, treatment and support, the symptoms improve with time.

While the patient is initially tired and possibly experiencing pain or discomfort, it is important they gradually begin doing things for themselves for example reaching for water, tissues, feeding themselves, moving up and down and side to side in the bed and walking longer distances. It

is not unusual to feel even more tired and sore after starting an activity, but it is important to continue. Eventually this discomfort eases.

A similar challenge occurs with eating, as intake must slowly increase to supply the nutrients and energy needed to improve and aid healing. Although appetite may not have returned it is important to follow all suggestions of the treating team with regards eating and drinking.

Tactics to help with eating

  • Eat small frequent amounts until your stomach can tolerate larger volumes
  • Eat high quality and healthy foods, rather than empty calories
  • Arrange for family to bring in food you enjoy. Check with transplant staff if there are any restrictions.

It is also very important to drink water to protect your kidneys from the medications used for immunosuppression. Generally, a person needs to drink 2 to 3 litres of water a day and this should continue after discharge and be ongoing. When it is hot and humid you should increase your water intake. Please seek advice from the treating team.

Patients will need to learn about their medications so that they can manage them at home. More on medications in Step 10: Medication for life.

Strategies for success

  • Plan rest periods after activities
  • Eat, drink and move around as advised
  • Limit numbers of visitors to reduce tiring
  • Involve visitors in education process.

In this guide:

  1. Step 1: Waiting for the transplant
  2. Step 2: Carers
  3. Step 3: The gift of a donor liver
  4. Step 4: Admission for the transplant
  5. Step 5: The transplant operation
  6. Step 6: The intensive care experience
  7. Step 7: The transplant unit
  8. Step 8: Exercise is for life
  9. Step 9: Nutrition
  10. Step 10: Medications for life
  11. Step 11: Leaving hospital, attending clinics and other details
  12. Step 12: Life after transplantation
  13. In conclusion

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