Recovery in hospital

Once you are in a more stable condition, you will be transferred to the Cardiothoracic High Dependency Unit (CTHDU). This ward provides specialist care for patients who have had major heart or lung surgeries. It is for patients who no longer need intensive care but still need more monitoring than a typical ward. Your nurse will have a few other patients to look after. Moving to the CTHDU is a sign that you are recovering well as you no longer need 1-to-1 support.

The post-transplant team will spend this time helping you get stronger and preparing you for aftercare at home. You will then be moved to a specialist ward when you are getting closer to discharge. Every patient is different, so it is hard to predict how long you will be in hospital. The team will tell you and your family when you are improving enough to prepare for discharge.

Visitors

You can have 2 visitors at a time. Visiting hours are strictly Monday to Sunday from 2pm to 4pm and 6.30pm to 8pm.

• All visitors should strictly follow infection control guidelines. This includes wearing a mask, keeping hands sanitised, and not touching any medical equipment. They should never visit the hospital if they're feeling unwell, or have been unwell in any form in the last 3 days.
• Children can only visit with permission from the nurse in charge and with adult supervision.
• Flowers or plants are not allowed as the pollen could affect your breathing.
• If visitors bring in outside food, they should strictly follow food safety guidelines. Store food in the refrigerator in your room.

Before discharge, you will be visited by a post-transplant nurse specialist. They will give you information about lifelong care, transplant clinic appointments and the lifestyle changes you will need to make now that you've had your transplant. They will help you get whatever additional equipment you will need at home, such as a nebuliser machine. It is important that a family member or care partner is available for this meeting.

Medications

Your new medications are essential for preventing organ rejection, infections and other complications. You will be taking them for the rest of your life, so it is crucial to stay organised so you never miss a dose. Learning all about your new medications will be a major part of your hospital recovery and preparing for discharge. By the time you are discharged, you should be able to take your medications yourself and log them in your medication diary. The nurses and pharmacist will help you get set up with a medication routine before you go home.

For more information, go to Medication after transplant.

Physiotherapy

Your physiotherapist will continue working with you to become more independent with day to day activities like getting in and out of bed, getting dressed and washing yourself.

Once you’ve achieved that, the next goal is to get you back to exercising. This includes walking, and using the exercise bike. You will need loose fitting clothes and shoes, such as t-shirts, tracksuit, and sandals with Velcro straps.

By the time you are discharged, you should feel comfortable doing your exercise programme independently so you can continue on your own at home.

For more information, go to Exercise after transplant.

Nutrition

As you are getting ready for discharge, the dietitian will prepare a personalised nutrition plan for you to follow at home. They will also educate you and your family about the importance of food safety after a transplant.

For more information, go to Nutrition after transplant.

Speech and swallow

If you have any ongoing difficulties with swallowing or your voice, the speech and language therapist will continue to work with you in your recovery.

Preparing your home

Before your discharge, your care partners should prepare your home so it is ready for your return.

• Give the home a thorough cleaning to reduce the risk of infection.
• Where possible, ensure your family members and those you live with have the flu vaccine. They should also be aware of the importance of hand washing and general hygiene.
• Put 4 inch blocks under the legs at the head of your bed so it is at a slight angle. This minimises the risk of your lungs getting damaged by heartburn and will help you sleep better.
• Make sure there is no construction or renovation work happening at your home. It could contaminate the environment and make you unwell.

A detailed discharge letter will be sent to your GP and local respiratory consultant so they know all about your surgery and recovery.

Prescriptions

When you are discharged from hospital, the team will give you enough medication to last you through your first week home. They will also give you prescriptions you’ll need to fill yourself. The transplant team will continue prescribing your high-tech drugs but your regular repeat prescriptions should be written by your GP.

It's important to think about which pharmacy you or your care partner will bring the prescription to since you’ll need to continue filling the prescriptions for the rest of your life. It’s helpful to establish a relationship with the pharmacy as they will be an important support to you.

Transport home

Your care partners will need to organise for someone to drive you home from the hospital. Remember not to use public transport for the first 6 months after discharge because of the risk of infection. This includes trains and buses.

Leaving the hospital can be an emotional experience. A lot has happened since you first arrived. On the one hand, you may be relieved that you have survived all you have been through and gotten your long-awaited transplant. On the other hand, you have lifelong medications to take and hospital visits to manage. You will need to figure out your 'new normal'. Patients have told us they’ve experienced some anxiety about leaving the safety and security of the hospital environment, and reentering everyday life where they have to manage on their own.

It is a lot to take in, and it is normal to experience a range of emotions. Be gentle with yourself during this adjustment period. You can always ask your GP or the transplant team to connect you with the extra support you may need.

For more information, go to Mental health after transplant.

Manage expectations

Many patients expect to be more active or feel better than they do. Please remember that recovering after a transplant takes time and patience. Try not to put any unnecessary pressure on yourself. If you have any concerns about your ability to do things or your recovery, discuss them with the post transplant nurses.