Our immune systems are pretty amazing. For all of the times that we actually feel sick, there are many more instances when our immune systems are exposed to and attack something that is not good for the body, and we’re none the wiser. In some cases our immune systems are overachievers, more commonly referred to as an auto-immune response. Derek’s disease, PSC, is in the family of auto-immune diseases. What is killing his bile ducts and ultimately his liver is his own immune system. Once Derek receives a portion of my liver, his body will spend the rest of its life confused; desperately trying to kick out the foreign object that has been placed inside of him. As a result he will have to be immunosuppressed.
“Immunosuppressant medications that stop the body from rejecting the transplanted organ are also an important part of life after transplant surgery. In general, the suppressed immune system can be slower in defending against germs. Transplant recipients may be somewhat more vulnerable to infections and may find it more difficult to recover from certain infections and illnesses. This is especially true for the first 6 months after surgery but will remain an ongoing concern. You can protect your health by following good prevention practices to avoid illness and injury and by seeking treatment early when illness does occur.” [Source]
We’ve been told that initially, Derek will be given large doses of steroids and and a heavy regimen of immunosuppressants to help his body transition to life with a new liver. Over the years, the way in which doctors medicate organ recipients has changed dramatically and it has increased the survival rate of transplant recipients considerably. There is a balance that must be achieved in the transplant recipient’s body through diligent testing and strict adherence to medication schedules in order to ensure the body will not reject the organ as well as ensure the body can at least partially protect itself from illness. As he recovers, the immunosuppression will be scaled back to a level that is best suited to Derek’s individual situation.
This means that in the early stages of Derek’s recovery he will be more susceptible to illness and as a result, all of us that care for him must be mindful of our own health and hygienic practices. For at least the first 6 months to a year after surgery, Derek’s exposure to children, large crowds and anyone who may be sick, will be very limited. It means that if you come to visit, we may ask that you leave your children at home for Derek’s health and safety. If you’re recovering from a cold or flu, we may ask that you come back when you are fully recovered and show no symptoms of illness. It means I will likely be a little crazy about people washing their hands thoroughly, with hot soapy water, when they come to visit. It also means that food preparation will have to be performed with strict adherence to hygiene and all foods will need to be cooked to ensure no little bacteria decide to hitch a ride into Derek’s gut.
We’re both a little unclear about the scope of the precautions that will need be taken during Derek’s recovery. There is a meeting planned before our surgery to go over some of these questions. Once we find out the answers we will be sure to share them here as a resource so everyone will have all have the necessary information to ensure Derek gets the best possible care.