After the heart transplant operation

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After a heart transplant, your child will need to stay in hospital for at least two to four weeks. Learn about what is involved in your child's recovery.

Key points

  • Your child will start immunosuppressants right after transplant.
  • Side effects of immunosuppressants will most likely happen in the first six months after your child's transplant.
  • Your child should avoid foods with salt and foods with a lot of animal fat and cholesterol as they may increase the risk of getting post-transplant coronary artery disease.

After a heart transplant, your child will need to start taking drugs to suppress their immune system and make changes to their diet. This page explains how immunosuppressants will affect your child and why it is important to avoid certain foods.

What happens after surgery?

After the surgery, if your child has no medical complications before, during, or after the transplant, they will stay in hospital to recover for two to four weeks. Most of the recovery will take place in the critical care unit (CCU) for five to eight days after the transplant. If your child was very sick before transplant or if complications have occurred, your child’s stay in the CCU may be much longer.

Your child will have various tubes and lines in place:

  • a nasogastric (NG) tube to feed them
  • an endotracheal tube attached to a ventilator that will help them breathe
  • chest tubes to drain extra fluid from around the heart and lungs
  • a urinary catheter
  • pacing wires, if your child needs a pacemaker

Right after transplant your child will be started on drugs to suppress the immune system. These drugs are known as immunosuppressants. Drugs will also be provided to ease the pain that will follow the operation.

The doctors and nurses in the CCU will closely watch how your child’s heart, lungs, kidneys, and stomach are working. Your child will have many tests, including blood work, chest X-rays, and echocardiograms. One week after transplant, your child will have the first heart biopsy.

What are the side effects of immunosuppressants?

There are side effects that will most likely happen in the first 6 months after your child's transplant. This is when your child is taking the highest amount of immunosuppressants. These are some of the most common side effects:

  • a bigger appetite or weight gain, particularly around the neck, back, and face
  • more hair growing on the face, arms, and legs
  • high blood pressure
  • acne on the face, in older children and teenagers
  • weak bones that may break more easily
  • headaches
  • shaking
  • stomach cramps and diarrhea
  • higher levels of sugar in the blood
  • changes in the composition of the blood
  • damage to the kidneys or liver

What about your child's diet?

The immunosuppressant medicines may affect your child's appetite and weight after the operation, so a clinical dietitian will help you and your child make sure that they eat healthy foods. Keeping a good weight will keep your child's new heart healthy.

It is important that your child eat foods that have little cholesterol and not too much salt. Foods with a lot of animal fat and cholesterol may make the chance of getting post-transplant coronary artery disease higher. Foods high in cholesterol can cause a thickening of the coronary arteries. Your child may also have high blood pressure after the transplant, so should not eat foods high in salt.

The foods your child eats may change greatly after the operation. This is particularly true if, before the operation, your child had a restricted salt and fluid diet. After the transplant, your child should have lots of liquids to make sure that the medicines are well washed out through the kidneys.

What about exercise after surgery?

After your child gets a new heart, they will be able to do lots of new things. A physiotherapist will work with you and your child so that they can get stronger and be able to exercise more. Your child will start doing exercises, called a physiotherapy program, in the hospital. Your child should continue to do this physiotherapy program after they go home from the hospital.

Last updated: December 11th 2009