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Lung Transplant Update | Penn Medicine

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Monday, July 21, 2014

Practicing Food Safety After Transplant

One important way to protect yourself after a transplant involves making safe food choices and practicing safe food-handling rules. The medications you must take after transplantation suppress your immune system to prevent your body from rejecting your new organ. Suppressing your immune system also increases your risk of infection.

Patients who have had transplants experience
weakened immune systems and need to protect themselves from all infections. Foodborne illnesses, sometimes called food poisoning, can be caused by raw or undercooked foods and are a real threat to transplant recipients. The Centers for Disease Control and Prevention (CDC) report that every year as many as 76 million people get sick from foodborne illnesses. Those at highest risk for those illnesses are the very young, the very old and those who have weakened immune systems.

Foods to avoid after transplant include:
  • Raw seafood like clams, oysters, sushi and ceviche
  • Raw, rare or undercooked meat, poultry and fish
  • Raw or undercooked eggs
  • Foods containing raw eggs like cookie dough or homemade eggnog
  • Unpasteurized milk and unpasteurized cheese
  • Unpasteurized cider
  • Bean and alfalfa sprouts
It is also important that you, and anyone who cooks for you, handle food safely. The following suggestions can help protect you from foodborne illnesses. Some of these ideas may seem simple, but it is easy to overlook these important steps.
  • Be clean. Always wash your hands with hot soapy water before beginning any food preparation. Keep the food preparation area and all utensils used during preparation clean. Replace sponges regularly. Wash dishcloths often. Consider using disposable paper towels. Wash all fruits and vegetables carefully.
  • Keep things separated. Protect yourself from cross contamination. Cross contamination can occur in your grocery cart when you place a package of meat that is leaking juices on top of other foods. It can also occur in the refrigerator if the juice from thawed meat drips onto other foods. Purchase multiple cutting boards and use one just for meat, another just for vegetables and one for bread. Clean the cutting boards thoroughly after every use. Any dish that has held uncooked food should be washed before using it for the cooked product.
  • Cook as directed. Always cook foods to the recommended temperatures. A food thermometer helps insure you meet this goal. Suggested temperatures:
    • Steaks, roasts and fish: 145 degrees F
    • Pork, ground beef and egg dishes: 160 degrees F
    • Chicken and poultry: 165 degrees F.
  • Chill. When food shopping, especially during hot weather, return home promptly and refrigerate perishables. Refrigerate leftovers quickly after a meal. Thaw frozen foods in the refrigerator, not on the counter. You may want to avoid salad bars and buffets when eating out as those foods may be held at room temperature for an extended length of time.
  • Always check the label of perishable foods for the “Sell-By” date. Do not use foods after the date listed.
  • Some basic rules: Keep hot foods hot and cold foods cold; and when in doubt, throw it out.

Additional information about food safety can be found on the CDC website.

Author: Carol Bergen, MS, RD, CSR, LDN, Clinical Dietitian Specialist

Thursday, July 17, 2014

Penn Medicine Recognized as Pennsylvania Donate Life Hospital Challenge Winner

The Hospital and Health System Association of Pennsylvania (HAP) recognized Penn Medicine as the health system with the “Highest Total Points Achieved” for its efforts to increase donor awareness and designations during the 2014 Pennsylvania Donate Life Hospital Challenge.

HAP partnered with the Pennsylvania Department of Health, the Gift of Life Donor Program and the Center for Organ Recovery and Education (CORE) – the organ and tissue procurement organizations serving PA – to support the 2014 Pennsylvania Donate Life Hospital Challenge.

From February 28 to May 14, participating hospitals and health systems held activities to increase donor awareness and designations within their hospital families and communities, and captured those activities on a scorecard.

Penn Medicine received the “Highest Total Points Achieved for a Health System” honor for completing the widest variety of activities by a hospital or health system to help increase donor awareness. We subsequently attained “Platinum-Level Achiever” by reaching more than 1,000 scorecard points.

We are thrilled, and strive to spread even more awareness and inspire donations in the time to come.

Thursday, July 10, 2014

How Do the Lungs Actually Work?

Written by Lucas Van Bramer, Summer Student Contributor

We all know that the lungs are among our most important organs. They take life-sustaining oxygen into the body and get rid of gases like carbon dioxide from the body. Even though the lungs are so vital, many people do not know exactly how they work. Learning the individual parts of the lungs and their roles in the respiratory system allow patients to understand exactly how their breathing works. This may help to explain how certain disorders in the respiratory (breathing) system affect the body and how they can be treated. So, how do our lungs work?

The lungs, or rather, the respiratory system, can be “broken down” into five main parts: the upper airways, the trachea, the bronchi and bronchioles, and the alveoli. The lungs themselves only contain the bronchi (large air tubes), bronchioles (small air tubes) and alveoli (air sacs), but the pharynx (back of the throat) and trachea (windpipe) are important to lung function as well. By following the path of air as it moves into and out of the body, we can examine each part in detail.

The Upper Airways

The upper airways include the nasal cavity and mouth, the pharynx and the larynx. The reason these parts of the respiratory tract are all grouped under one name is that the purpose they all serve is to simply direct air into the lungs. As we breathe in, the upper airway warms the air and adds moisture to it so that it is more comfortable for our lungs. Many people are familiar with the parts of the upper respiratory system, which is the site of most common colds. The pharynx and larynx also have more common names, the throat and voice box, as well.

The Trachea

Once air moves down through the upper airways, it reaches the trachea, or “windpipe.” The trachea is basically a tube with an upside-down Y shape. It can be thought of as the first part of the lungs reached by air when inhaling. The trachea serves to direct air into the two lungs. The trachea has a protective coating of special cells that helps defend against inhaled dust and particles. This airway is also surrounded by muscles and rings of cartilage. These help the trachea to maintain its shape so that air can always pass to and from the lungs with ease.

The Bronchi and Bronchioles

After the air passes through trachea, it moves into arms of the upside-down “Y,” the large airways called the left bronchus and the right bronchus. A series of tubes, known as the bronchi (large tubes) and bronchioles (small tubes) are referred to as the bronchial tree because they resemble the branches of a tree that get smaller and smaller as they get closer to the leaves. These structures, similar to the trachea, carry air further into the lung and attach finally at the alveoli, which are like the leaves.

The Alveoli

The alveoli, also known as air sacs, are responsible for the most important work done in the lung: the transfer of gases. The alveoli are very, very small sacs of air attached to the ends of the smallest airways, the bronchioles. The air sac is made of a very thin membrane (tissue). When we breathe air in, oxygen moves across that membrane and into the small blood vessels that go through the lung. Carbon dioxide and other gases from the blood cross the membrane and are then exhaled through the same structures that oxygen-rich air came in. Then, the process is repeated over and over again.

Understanding how our lungs work is not a very complicated issue when we take this problem and break it down into parts. This new knowledge can help patients understand how some of the more complex disorders and diseases of the lung affect the body.

Wednesday, July 2, 2014

To Swim or Not to Swim? Safe Swimming Tips for Lung Transplant Recipients

Summer is here and there are many opportunities to enjoy the warmer temperatures. For lung transplant patients, it's important to know what precautions might be necessary for you to enjoy summer fun safely. If swimming is on your list of warm weather activities, take a minute to check out this interview with Emily Blumberg, MD, a national expert in transplant infectious disease and a member of the infectious disease team here at Penn. We asked Dr. Blumberg to explain the risks involved in swimming and her recommendations for avoiding infections while enjoying the activity. Here are her recommendations.

Why is it important for lung transplant recipients to learn about safe swimming?

We know that significant infections can result from water exposure, so it’s critical for lung transplant recipients to understand:
  • where it is safe to swim;
  • where it is not safe to swim; and
  • when it is not safe to swim.

Where is it safe for lung transplant recipients to swim?

It’s safe for lung transplant patients to swim in chlorinated pools and, in most cases, the ocean is also okay but patients should avoid swimming in the Chesapeake because the presence of some dangerous bacteria has been found there in recent years.

If lung transplant patients experience any kind of abrasion while in the ocean, the abrasion should be thoroughly cleaned with soap and an uncontaminated water source - not the water you are swimming in - to minimize the risk of infection.

Where is it unsafe for lung transplant recipients to go swimming?

The easy way to remember where it’s not safe to swim is remember that freshwater swimming represents a high risk for infection. So it’s not safe for lung transplant recipients to swim in fresh water of any kind, which includes ponds, lakes, creeks, rivers and streams. Since it’s often part of vacation recreation, it’s probably helpful to mention that, because of several infection risks, hot tubs should be avoided.

When is it unsafe for lung transplant recipients to go swimming?

If a lung transplant recipient has an open wound of any kind it is not safe to swim at all. In addition, swimming should be avoided if a patient is being treated for rejection.

Remember, if you have questions about safe swimming, before you go, contact your transplant coordinator to verify that swimming is safe option for you.