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Staying Healthy
The first and most important thing you need to do to stay healthy is to take every dose of your medications, every day. By staying on track with your medications, you can protect your organ from rejection and keep it strong. That means taking your medications even when you are feeling good—so you can keep feeling good.
Staying healthy during the first year also means watching out for infection, managing side effects, and taking care of your mental health.
Visit the Healthy Living section for some other tips on keeping yourself moving in the right direction—including healthy recipes that are good and good for you.
Watching Out for Infection
The medicines you take to prevent rejection work by slowing down your body's immune system. While they protect your organ from rejection, they also lower your body's ability to fight infections. Wash your hands often to get rid of germs that can cause infection. In addition, avoid touching your eyes or nose, since this is the main way germs are spread.
Infections can become very serious and even lead to death if left untreated, so you will need to know the warning signs of infection. Contact your transplant team right away if you have any of the following symptoms:
- Fever over 100°F (38°C)
- Flu-like symptoms such as chills, nausea, vomiting, diarrhea, tiredness, headache, dizziness, or body aches and pains
- Coughing up yellow or green mucus
- A dry cough that lasts for more than one week
- Severe diarrhea
- A burning feeling when you urinate
- Vaginal discharge or itching
- A wound that oozes fluid, does not heal, or feels warm
- Swelling, warmth, redness, pain, or tenderness of an arm or leg
Managing Side Effects
High cholesterol
High cholesterol is common after transplant surgery. If cholesterol levels get too high, blood vessels may become partially clogged, slowing or blocking the flow of blood. This increases the risk of heart disease and stroke. Therefore, it is important for you and your doctor to work hard to minimize risk factors for heart disease, including controlling cholesterol.
Many cases of high cholesterol following transplant surgery are caused by immunosuppressive drugs. Steroids, cyclosporine (Neoral®), and sirolimus (rapamycin, Rapamune®) have been associated with increases in cholesterol. However, Prograf is not generally linked to marked increases in cholesterol levels.
Talk to your doctor about your immunosuppressive medications and the risk of increasing cholesterol levels. Your doctor or nutritionist can also recommend a diet plan to help keep your heart healthy. Additional medications may also be required to lower your cholesterol levels.
High blood pressure
Some transplant recipients develop high blood pressure (also called hypertension) because of their immunosuppressive medications. People with post-transplant hypertension usually find that their blood pressure can be effectively managed.
Regardless of the cause of your high blood pressure, you should maintain a healthy lifestyle. There are a number of ways to increase your cardiovascular health and lower your blood pressure. These include:
- Stop smoking
- Eat a low-salt, low-fat, high-fiber diet
- Exercise
- Manage your weight
- Take blood-pressure–lowering medications
Consult with your transplant team before undertaking any lifestyle changes. Your doctor may prescribe medicines to help you lower blood pressure. Many times, blood pressure cannot be controlled with one drug, and others will need to be added.
New-onset Diabetes
Some anti-rejection medicines can cause high blood sugar. Steroids, cyclosporine, and Prograf have all been associated with the development of new-onset diabetes after transplant surgery. A higher incidence of diabetes has been reported with Prograf compared to cyclosporine; however, post-transplant diabetes in patients taking Prograf has a high likelihood of being reversed. In fact, long-term data demonstrated that 41.2% of these patients no longer required insulin treatment at 5 years post-transplant. African American and Hispanic transplant recipients appear to be at higher risk for developing diabetes, as are overweight recipients or those with a family history of adult-onset diabetes.
Reducing the dose of anti-rejection drugs, or changing medications may help blood sugar levels return to normal.
Never change your dosing or medication on your own. Talk to your doctor, who will decide what is right for you.
Physical Side Effects
Some of the medicines you will have to take may cause unwanted changes to the way you look. Steroids are linked to weight gain, acne, and a puffy ("moon-faced") appearance. Some medications can cause increased gum size and the growth of unwanted hair on the face or body, while others are associated with unwanted hair loss.
Talk to your doctor about any side effects that concern you. It may be possible to control these effects by changing doses or medicines. Ask your doctor about choices in anti-rejection medications.
Taking Care of Your Mental Health
The period before and after a transplant can be very stressful. It is normal for people in this situation to be nervous or depressed to some degree. Your loved ones may be having similar feelings. Ask your transplant team about counseling services that can help you, your family, and your friends get through this period.
After your transplant, the steroids you receive to protect your new organ may also affect your mood. Talk to your doctor about ways you can minimize steroid use.
Prograf Prescribing Information 
Prograf Patient Information
Prograf Safety Information
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