After Organ Transplant Surgery
The average recipient spends months or even years anticipating organ transplant surgery, waiting and hoping for the day that will provide a second chance at a healthy life.
Out of necessity patients must focus on dealing with their life-threatening illness and hoping for surgery rather than learning skills to help them cope after a transplant that may not happen. With the emphasis on maintaining heath and hope preoperatively, many patients are unprepared for the changes in their lives and health after the transplant surgery.
Coping with these changes requires support, diligence and a willingness to prioritize a healthy lifestyle and maintain a healthy organ.
Emotional Issues After An Organ Transplant
There are issues that are unique to organ transplantation that the average surgery patient does not experience. In the majority of cases, a patient who is waiting for an organ knows that for an organ to become available an appropriate donor must die.
There is an emotional struggle between maintaining hope for a transplant and dread, knowing that a stranger will die before that becomes possible. Transplant recipients often acknowledge that they feel survivor’s guilt, having benefitted from the death of another.
It is important for recipients to remember that family members of donors report feeling that being able to donate organs was the only positive thing to happen during a heartbreaking time. The correspondence they receive from organ recipients can help the feeling of total loss after a loved one dies.
Being able to establish a relationship with a donor family, even if by mail only, can bring a sense of peace. For the donor family, a part of their loved one lives on. Some families and recipients choose to meet after corresponding, forging a bond over their shared experience.
Addiction & Depression After A Transplant
The weeks and months immediately following surgery can be very stressful for an organ recipient, making it an especially difficult time to maintain sobriety for those who are battling addiction.
Alcohol, tobacco and drugs are routinely tested for when patients are waiting for transplant, as abstinence is a condition of being on the waiting list at most transplant centers, but once surgery takes place the temptation to return to old behaviors can be overwhelming.
It is essential for recipients to maintain their healthy habits, as these drugs can be toxic to the new organs. There are many 12 step programs available for patients battling addictions and their families, inpatient and outpatient treatment programs and support groups.
Smokers can discuss anti-smoking prescriptions with their surgeon and many other types of therapies for smoking cessation are available over the counter.
Depression after surgery is not isolated to people with unrealistic expectations, it is common with chronic illnesses and major surgeries. While many have a tendency to deny there is a problem, confronting depression and seeking treatment is essential to maintaining good health.
Patients who are depressed are more likely to return to addictive behaviors and less likely to take an active role in their recovery and long term health.
Living Related Donor Organ Transplant Issues
A minority of organ recipients have a liver segment or kidney donated by a living family member or friend, which presents entirely different issues than those of an anonymous donor. A living donor may have a significant period of recovery after surgery, with additional time spent recuperating at home.
While surgery bills are paid for by the recipient’s insurance, lost wages and pain and suffering are not, and may cause hard feelings among family members. Disability insurance may provide financial relief, but there may be issues after a donor is discharged regarding whose insurance pays for medications that are part of aftercare.
A feeling of “owing” the friend or relative who is a donor is not uncommon. There are also donors who have complications after surgery. There are instances of the “sick” family member having a transplant and being discharged from the hospital before the “well’ donor.
Some people also experience depression after donation, a serious low after the euphoria of being instrumental in saving a life. Surgical complications or psychological issues after donation may cause the recipient to feel guilty for having “caused” these problems.
Ideally, a conversation regarding all the issues of donation should happen prior to surgery, and should include the financial and emotional aspects of donation, in addition to the physical issues. The discussion should also include the expectations of everyone involved, and whether or not these expectations are realistic.
When this conversation is taking place after surgery, a frank discussion may be necessary to determine what is a realistic expectation and what is not. An organ donor may have expectations of the recipient that are beyond financial issues, but are equally important, regarding the recipient’s health and wellbeing.
A donor that gives a section of their liver to a relative who needed it after abusing alcohol may be very sensitive to seeing that person drinking eggnog at Christmas when it has never been an issue previously.
The donor has an emotional investment in the health of the recipient that has been changed, and abusing the organ may feel like a slap in the face. These issues must be discussed in an honest and open way, without judgment, to have a healthy ongoing relationship.