Heart Transplant Program Preventing Infection Post-transplant

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Preventing infection while on immunosuppressant drugs

Our goal is to help your child live as full and normal a life as possible, before and after transplant.

Below are guidelines that can help decrease the risk of infection. Being knowledgeable and making safer choices are the best defenses against infection.

These guidelines are especially important:

  • During the first six months after transplant when the immune system is most suppressed
  • When immunosuppression is increased, such as during episodes of rejection

Your transplant team will explain how suppressed your child’s immune system is and give you specific steps you can take to decrease the risk of infection.

Remember, your child’s transplant team is here to help keep your child healthy. Please let us know if you have any questions or concerns.


1. Hand washing:  

  • Encourage your child and the other members of your family to wash their hands with soap and water and/or use an alcohol-based hand sanitizer such as Purell®. Using products labeled “antibacterial” is usually not needed unless recommended by your transplant team.
  • Always wash hands before eating, after using the bathroom or changing diapers and after handling animals.

2. Avoiding sick people:

  • Avoid people who are obviously sick, especially if they have symptoms of a respiratory infection (e.g. cough, cold, runny nose, fever).
  • Tell your relatives and friends before the transplant not to visit if they are sick.
  • Ask your child’s school nurse or day-care coordinator to let you know of any infectious outbreaks in the class, school or day-care center.

3. Yearly flu shot

  • Transplant recipients and their household members should get a flu shot every year. Do not get the nasal vaccine as this is a “live” vaccine and can make the transplant recipient sick.

4. Immunizations

  • Discuss immunizing your child after transplant with your transplant team. There may be restrictions on certain immunizations after transplant.
  • Make sure that other members of your household are up-to-date with their immunizations.

5. Food Safety

  • Be careful of food poisoning, especially during the warm summer months. Keep hot foods hot and cold foods cold. Refrigerate leftovers within two hours of cooking.
  • Certain foods may be restricted after transplant, depending upon your level of immunosuppression. Talk with your transplant team about restrictions to follow after transplant and during times of increased immunosuppression (such as rejection episodes).

6. Animals:  

  • Interacting with pets is usually restricted only if the pet is ill. Pets should receive consistent veterinary care to keep them in the best health possible.
  • Avoid letting your child handle animal waste or clean animal/bird cages, litter boxes and fish tanks.

7. Water Safety: Germs can spread easily in water, so certain precautions are important to avoid infection.

  • If you have a well, have your water tested. Your transplant coordinator can educate you on what tests should be conducted.
  • Be aware of local news reports about avoiding contaminated water (wells, municipal water, beaches, water parks). Please follow orders issued about local water supplies, such as avoiding swimming at beaches that are closed and following boil water orders.
  • Never let your child drink from lakes, streams or ponds.

8. Dental Care: Good dental care is important for transplant recipients.

  • Make sure your child brushes and flosses daily.
  • Always speak with your transplant team for special instructions prior to the first dental appointment post-transplant.

9. Travel:  

  • Please visit a travel clinic, such as the one at Boston Children's, when planning international travel. Travel clinics assist people in preventing infection while abroad through education and immunization. This is especially important when visiting developing countries.
  • Ask your transplant team if there are any restrictions regarding immunization before the Travel Clinic appointment.
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