Key points
- You’ll always be at risk of rejection or infection. The team will monitor you for any new warning signs.
- You’ll need to attend post transplant clinic appointments for the rest of your life. As you recover, the appointments will be less frequent.
- Because your lifelong medication puts you at risk of certain diseases, you’ll also need to follow up with different specialties from time to time.
- You should stay up to date on routine medical screenings and certain vaccinations. For guidance, consult your GP.
Adjusting to your new lifestyle
Your first few weeks after leaving hospital will be an adjustment as you settle back home and establish new routines. You will have to get used to new medications, daily exercise and your nutrition plan. You’ll also need to make changes to your lifestyle and avoid certain activities.
If you feel unwell
You’ll need to pay attention to how your body is feeling, and monitor yourself for any new issues. If you ever feel unwell, don’t delay seeking help.
When you’re unwell, it's important to know where to go so you can get the right care at the right time. In general, the transplant clinic focuses on lung related issues. For emergencies, go straight to your nearest emergency department (ED). For anything that’s not lung related or an emergency, go to your GP.
For more information, go to If you feel unwell after transplant.
Post-transplant clinics
After transplant, you will have lifelong follow-ups with the post-transplant team in the Mater. This is so they can monitor you for signs of rejection or infection and the various conditions that you are now at risk of developing. At these appointments, the transplant team will help you to reduce your risk and stay well.
Monitoring for rejection
The transplant team can detect rejection episodes before you notice symptoms through routine exams during your clinic visits, so make sure to keep to your appointment schedule. The team can usually treat a rejection if it is detected early enough. Depending on your circumstances, they may also offer remote monitoring for rejection.
The team can detect a rejection through:
- physical examination and symptom reporting
- blood tests
- lung biopsy
- chest x-ray
- lung function test
Monitoring for infection
All patients will have episodes of infections. You will always be at higher risk because of your immunosuppressant medications. Preventing infection not only protects the new lung(s) but also plays a key role in improving long-term survival and quality of life after transplant. You can help to avoid infection by:
- paying careful attention to hygiene
- avoiding exposure to infectious diseases
- strictly following your medication routine
- attending all follow-up appointments
You will be very carefully monitored for any signs of new infection, especially fungal infection, which is common. We monitor infections with a procedure called a bronchoscopy, which involves putting a camera into the lung to see if the infection is growing. It’s important to catch an infection early so we can treat it properly.
Here’s what a typical schedule looks like, though it will vary depending on how you are recovering after transplant:
| After discharge | Appointment schedule |
|---|---|
| Week 1 to 6 | Weekly |
| Week 6 to 14 | Every 2 weeks |
| Month 3 to 9 | Once a month |
| Month 9 to 12 | Every 6 weeks |
| 1 year after discharge | Every 4 months (unless your team feels you need more) |
These clinics are always in the morning and can last a few hours. At each appointment, you will meet with the lung transplant consultant and/or post-transplant nurse for a check-in. Before you meet the team, you will have:
You may also have a chest x-ray. Follow the instructions on your appointment letter to find out how to prepare and where to go.
Preparing for your post-transplant clinic appointments:
- Bring one of your care partners with you.
- Have a think about what you would like to ask at the clinic. Keep a running list of any questions that have come up since your last visit.
- Bring all your medications and your medication journal. Do not take your morning medications until after your blood test is completed.
- There is a chance that the team may ask you to stay overnight in the hospital, so pack an overnight bag with a change of clothes and toiletries.
- There is no need to fast before your appointment unless the clinic tells you otherwise.
- Bring some snacks or water to keep you going in case of long wait times.
- Give yourself extra time to find parking near the hospital.
- Arrive at the clinic wearing a face mask and remove it once you leave the hospital.
Managing cystic fibrosis (CF) after transplant
Even though a transplant will prevent cystic fibrosis from impacting your new lung(s), you will still have the condition. It's important to continue managing other aspects of your CF. This includes managing:
- sinus problems
- gastrointestinal issues
- diabetes
You should also have regular screenings, including:
- colorectal screenings
- liver testing, as required to look for CF liver disease
- bone density scans
- checking your vitamin levels (A, D, E, K)
Your CF specialists will continue to play an important part of your healthcare alongside the transplant specialists.
“If you are a cystic fibrosis (CF) patient, you may continue to have your CF appointments in your current CF centre or this care may be transferred to the Mater.”
- Katherine Raleigh, Post transplant nurse
Other medical appointments
Regular blood tests
All patients need to complete a blood test every 6 to 8 weeks. You should schedule this yourself with your GP.
Local health appointments
You should still attend appointments with your local respiratory consultant and your GP as needed. They’re responsible for your care outside of transplant. Your GP is often good at managing chronic conditions like blood pressure, diabetes, lipids, mental health, and sexual health. Always keep the transplant team in the loop of any advice given.
Follow-ups with other specialties
After transplant you are at higher risk of developing certain conditions such as:
To learn more, go to Other risks. To keep an eye out for warning signs, you will need to meet with other specialists from time to time. These specialists may include:
- skin (dermatology)
- digestion (gastroenterology)
- diabetes (endocrinology)
- kidney (nephrology)
- heart (cardiology)
- nutrition (clinical nutrition and dietetics)
- ear, nose and throat (ENT)
- brain (neurology)
- mental health (psychiatry and/or psychology)
The specialists will stay linked in with the transplant team. If you or your team have any questions, contact the transplant team for advice.
“Always let the transplant team know if you are prescribed any new medications from other specialties.”
- Susie Towell, Post transplant clinical nurse specialist (CNS)
Screenings
You’ll need to keep up to date with regular screenings by other specialties, in line with HSE guidelines. Talk to your GP for more information.
Vaccinations
- Some vaccines will be less effective because of your immunosuppressant medications. Even so, all patients should stay up to date with their vaccinations to reduce their risk of getting sick.
- Transplant patients should never take a live vaccine. Confirm with your GP or pharmacist that any vaccine isn't live before receiving any injections.
- Some vaccines are not covered by the HSE, so you may have to pay for them yourself.
- Everyone in your household should also stay up to date with their vaccinations to reduce your exposure to infection.
“If the vaccine isn’t listed above, please ask the transplant team first to make sure it’s safe for you.”
- Katherine Raleigh, Post transplant nurse