A heart transplant is not a cure. In fact, a heart transplant requires a lifetime commitment by both the caretaker and the patient. Although the transplant team at Lurie Children’s will continue to provide you with support and education, it's up to you to follow their instructions.
Whenever possible, all required immunizations should be given before transplant. After transplant, your child should not receive any routine immunizations until approval is given by the transplant team (about 12 weeks after transplant). Modified immunizations will then be given according to the usual well-child schedule.
Because of the immunosuppressant medications, your child should never receive live virus vaccines including MMR (Measles, Mumps and Rubella), OPV (oral polio vaccine), or varicella. Infants and children who are immunosuppressed should receive the inactivated polio vaccine (IPV). All members of the family should also receive IPV. Family members can, however, receive the MMR. VZIG, a shot, is always given as soon as possible after your child has been exposed to chicken pox to lessen the severity of the disease. Call the transplant team if your child has been exposed to chicken pox.
Cleanliness After Transplant
In the first month after transplant your child will be on the highest dose of their immunosuppressant medication, which means that this is the time they’re more likely to get an infection. During this time, avoid crowded areas such as malls, theaters and grocery stores. If you do go to one of these public areas, go when other kids are in school and it is likely to be less crowded.
The most important guard against germs and infection for your child is good, consistent hand washing for all family members.
While you may visit the transplant team often, it is also important to follow up with your pediatrician to monitor your child's growth and development and help you with any problems not related to the heart (for example, an ear infection). It is important that your pediatrician is aware that your child has had a heart transplant and what their medications are. A summary letter is sent to your pediatrician after discharge from the hospital and after each visit.
Good oral hygiene is a way to keep your child healthy and free of infection. Before transplant, it is best to take care of cavities and other dental work. Regular dental check-ups are important to prevent infection, but should be avoided for the first six months after transplant when the amount of immunosuppressant medications are at their highest.
The transplant team will let you know when you may return for regular dental visits. Antibiotics must be taken as prescribed, before the dental visit, to prevent infection in the blood or heart. Notify your dentist of this when making the appointment for your child.
After transplant, the medications prescribed will cause sun sensitivity and put your child at a higher risk for skin cancer. It is important to always apply sun screen when outdoors and to check your child's skin often for irregular moles or growths. The transplant team may refer your child to a dermatologist for any suspicious skin conditions.
Hearing & Vision Evaluations
We recommend yearly hearing and vision exams. Children who are on Prednisone should be evaluated annually by an ophthalmologist. Also, some of the medications that your child received during transplant can increase the risk for hearing loss.
School is an important part of your child's life. The transplant team encourages children to return to school as soon as possible after transplant (about three months). While recovering in the hospital and at home, a tutor may help your child keep up with their studies. It is important for others to understand that once your child has received a new heart, they’re no longer ill but need to continue to take medications and be followed by the transplant team. Please contact the transplant coordinator if your child is exposed to any communicable diseases.