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Staying Healthy

Preventing Infection

The following are things you can do (or avoid doing) that will help prevent an infection. Your transplant doctor or nurse will tell you when some of these restrictions may be lifted.

  • Stay away from people who are obviously sick with the flu, a cold or chicken pox.
  • Wash your hands with soap and water before you eat and after you go to the bathroom.
  • Shower or bathe regularly. Wash you incision as you would any other part of your body. Do not use lotions or powders on your incision.
  • Clean cuts and scrapes with soap and water, and apply an antiseptic and a bandage.
  • Do not, under any circumstances, change the litter in the cat box or birdcage without gloves. This could cause a serious infection.
  • Do not garden, dig in dirt, or mow the lawn without gloves for six to eight weeks after your transplant. This could cause a serious infection.
  • If you are in a building or outdoors where there is extensive construction and dust and dirt in the air, wear a surgical mask to prevent inhaling certain infectious agents that may be in the air. It is better to avoid these areas as much as possible.
  • Brush and floss teeth daily.
  • Keep fingernails and toenails clean and trimmed. For hard to manage or ingrown toenails, see a foot specialist.
  • Talk to your doctor about getting the flu vaccine and the pneumonia vaccine. These do not contain a live virus and are safe for you to have.
  • Do not get any vaccine that contains a live virus like the smallpox or polio vaccine.
  • Talk to your doctor if someone in your house is going to receive a live virus such as the oral polio vaccine or diphtheria vaccine if you have not already been vaccinated.
  • Eat only thoroughly cooked oysters, clams or mussels, and avoid swimming in estuarine waters (where fresh and salt water mix) to minimize risk of serious infection from Vibrio vulnificus. You can read more about the dangers of this bacterium at
  • Do not expose yourself to cigarette smoke, either firsthand or secondhand.

Skin Cancer Prevention

You are at increased risk for skin cancer due to the medications you are on to prevent liver rejection. This is especially true if you are light skinned and have had a lot of sun exposure in your life. You can decrease this risk by avoiding burning or tanning in the following ways:

  • Avoid being out in the sun between 10 a.m. and 4 p.m.
  • Use sunblock (minimum SPF 30) and wear long pants, long sleeves and a hat to protect your skin.

Follow the American Cancer Society's "ABCD" rule for checking your skin for possible cancer:

  • Asymmetry: one side of the birthmark or mole is different from the other
  • Border: the edges are ragged, notched, irregular or blurred
  • Color: the color is not uniform and there may be shades of black or brown, with patches of red, white or blue
  • Diameter: the spot is bigger than a pencil eraser (6 millimeters across) or is growing in size

See a dermatologist immediately if you notice any of the above, or for a routine check-up after you have been on immunosuppressive medications for two to three years.

For more information about skin cancer in transplant patients, visit the AT-RISC Alliance. A collaborative effort among the International Transplant Skin Cancer Collaborative, the International Transplant Nurses Society, and the Transplant Recipients International Organization, AT-RISC uses education and awareness to help reduce skin cancer in patients who have transplants.

Changes to Skin and Hair

Your transplant medications can cause changes to your skin, such as acne, warts and dryness. In addition, your hair may become thicker or thinner, depending on which anti-rejection medications you take. Be sure to mention troubling symptoms to your physician and do not use any new medications without checking with your transplant team.

Primary Care

See your primary care physician regularly, and keep up with all recommended routine screenings, such as PAP smear, mammogram and prostate exam.

Dental Care

Good dental hygiene is very important after your transplant. Please follow the guidelines below.

  • Brush your teeth after each meal and at bedtime.
  • Floss your teeth gently every day.
  • Examine your mouth every day and call your doctor or nurse if you have sores, blisters, or white spots.
  • Visit your dentist every six months. Make sure the dentist knows what anti-rejection medications you are taking before he or she does any dental work.
  • You will need to take an antibiotic before having dental work to avoid a serious infection. Your dentist knows the guidelines for antibiotic use before dental work. Amoxicillin is the drug of choice. People who are allergic to penicillin can take clindamycin (Cleocin) instead of amoxicillin. People who are taking Prograf or Neoral should not take erythromycin, clarithromycin (Biaxin), or dirithromycin (Dynabac). Your dentist can prescribe these antibiotics.
  • Do not plan any routine dental work until six months after your transplant operation.
  • Neoral can cause an overgrowth of your gum tissue, which can become swollen and painful. Ask your dentist for oral hygiene tips to relieve the discomfort. If this becomes a serious problem, your doctors may consider a change in your medication. Discuss this with them.

Eye Care

You should visit your eye care specialist once every year. Patients with diabetes who have eye disease (retinopathy), will need close follow-up with their ophthalmologist after the transplant.

Special Health Issues for Women

  • Have a Pap smear once a year.
  • Perform a breast self-exam every month. The best time to do this is one week after your period ends.
  • The transplant team recommends that women avoid pregnancy for one to two years after a transplant operation and at any time if taking CellCept or Rapamune, anti-rejection medications. If you are considering getting pregnant, please discuss this with your transplant team. If you discover that you are pregnant at any time after your transplant, please contact the transplant team.
  • If you are sexually active after your transplant, it is necessary to use contraception each time you have intercourse. We recommend the diaphragm with a spermicidal gel or a condom (used correctly). We do not recommend oral birth control pills immediately after transplant, but your doctor may approve birth control pills at a later time. Be sure to discuss your method of birth control with your transplant doctor or nurse.
  • The transplant team recommends birth control because women may produce eggs two to six months after the transplant operation and before regular menstrual periods begin.
  • If you use tampons, choose the smallest size needed to meet your needs.
  • Change tampons frequently to avoid infection.
  • Do not use a tampon overnight.
  • If you are over the age of 50, ask your doctor about a screening colonoscopy.

Special Health Issues for Men

  • Perform a testicles self-exam every month. Call your doctor if you see or feel any abnormal or unusual lumps.
  • Men who are age 40 and older should have a physical every year, and it should include a screening for prostate cancer.
  • Although men may father children at any time, talk to your doctor before trying to conceive to be sure the medicines you are taking, such as CellCept, will not affect the baby.
  • If you are over the age of 50, ask your doctor about a screening colonoscopy.

Contact Information

Transplant Institute
Beth Israel Deaconess Medical Center
Lowry Medical Office Building, 7th Floor
110 Francis Street
Boston, MA 02215