Aetna Pharmacy: Transplants

What to expect with your transplant therapy
Thanks to modern science, many organs can be transplanted, including: the heart, lung, kidney, liver, pancreas, bone marrow, small intestines, and others.

Your transplant can help to increase the length and quality of your life. We want your transplant to be successful. To achieve this, we provide immunosuppressant, injectable and supportive transplant therapies.

When you order your transplant medications through Aetna Specialty Pharmacy®, you benefit from our Aetna Transplant Life Management^SM program. Through this program, you may receive a 90-day drug supply. We will check your benefits or insurance plan to make sure a 90-day supply is right for you. If you are a new transplant recipient, you are eligible to receive a backpack starter kit.

Your backpack starter kit will contain the following:

• Blood pressure cuff
• Thermometer
• Pill crusher
• Pill cutter
• Pill box
• The book "New Life (Lessons in Faith and Courage from Transplant Recipients)"

We also offer you fast delivery, experienced support, and so much more.

Call a nurse or pharmacist anytime
If you have questions about your transplant or your medications, we can help. Call anytime -- day or night -- to talk to a registered nurse or pharmacist.

Call us toll free at:

1-866-782-ASRX (1-866-782-2779) or
TDD: 1 (877) 833-ASRX (1 (877) 833-2779)

Types of transplants 

There are two sources for organ donation: living donors and cadaver donors. Living donors are usually a friend or a family member who is able to donate an organ or part of an organ to you. These donors must be tested to see if they are healthy enough to donate an organ and to identify whether the organ would be compatible with your body. If you are waiting for a cadaver donor, you will need to be sure that your transplant center has current phone numbers for you. Your transplant center will need to contact you immediately when an organ becomes available.

An extensive transplant team focused on your health 

Your surgeon performs your operation and monitors your progress afterward. Most of your questions about the transplant itself will be answered by your surgeon. Your surgeon will:

• Make sure your organ is functioning properly,
• Watch for any signs of rejection or surgical complications, and
• Help you with the medications you will take following your surgery.

Your medical specialist is a doctor who specializes in the treatment of the organ you are having transplanted (for example: a hepatologist for liver transplant, cardiologist for heart transplant, nephrologist for kidney transplant, etc.) This medical specialist handles all of your non-surgical care including:

• Organ function
• Rejection episodes
• Post-transplant medications

Your clinical support team

Aetna Specialty Pharmacy nurses and pharmacists are available to provide support and educational information to you and your family throughout the entire process. They can work together with your transplant team, your surgeon and medical specialist.

Our nurses and pharmacists will help to:

• Teach you how to administer injections, if needed
• Check how well you are staying on track with your medicine
• Maintain all of your medical information

Your Aetna National Medical Excellence Program^® nurse case manager is a registered nurse who specializes in case management of transplant recipients. He or she will work together with you and your transplant center to meet your health care needs within the guidelines of your health care benefits.

Your physical therapist will work with you to develop an exercise plan that will strengthen your muscles and help you to resume normal activities as quickly as possible after your transplant.

Transplants can be stressful. A psychologist or psychiatrist can offer you emotional and clinical support before, during and after your transplant.

Your nutritionist will work with you to establish a plan for healthy eating. This will help to enhance your quality of life before the transplant. This will also support your recovery following the transplant.

Your financial coordinator helps you to explore all of the options available to help pay for your transplant. He or she will work with you to identify primary and secondary benefits, Medicare and Medicaid, or alternate resources available.

Your social worker can help you understand family and lifestyle issues that you may encounter as a transplant recipient. Your social worker can also point you in the direction of community resources that may be beneficial to you and your family.

Your pharmacist will help your transplant team oversee the many complex medications you will take after your transplant and for the rest of your life. Your pharmacist will help to ensure that the new organ has the best chance for survival.

Get help managing your therapy 

Aetna Specialty Pharmacy is here for you. You will receive many helpful services, such as:

Assessment
As a new transplant patient referred to Aetna Specialty Pharmacy, you will be assessed to determine your medication needs. We will confirm some key information - like your age, weight, therapy, dose, any allergies, and shipping address. Tell us if you need help understanding your medication or how to use it.

You will also be assigned your Aetna National Medical Excellence Program nurse case manager. Your nurse case manager will keep in touch with you for at least six months to check how you are doing.

Clinical help
You can also talk to a nurse or pharmacist anytime. They can be reached toll free, 24 hours a day, 7 days a week.

Education
You will receive a welcome packet along with your first order filled by Aetna Specialty Pharmacy. It will explain our services and what to expect. If you have any questions, just call. If you need help with taking a self-injectable medication, a nurse or pharmacist is available to walk you through the process.

Medicare
Aetna Specialty Pharmacy is a Medicare provider. We maintain a Medicare team that determines if your medication meets Federal guidelines for coverage. If so, this team will appropriately coordinate your benefits coverage.

Transplant care plan
We make sure you always have the right medication and dose for your needs. If you want additional support, a nurse or pharmacist will contact you as often as you'd like

Extra service at refill time
A refill coordinator will call you one week before your refill is due. He or she will schedule your delivery and check to see how you are doing.

Your refill coordinator will ask you to confirm

• How you are doing with your therapy.
• If you are still taking the same specialty drug.
• If you are still taking the same dose.
• If you are having any side effects or signs of rejection.
• If you need additional supplies.
• Where you would like your next refill delivered.

If you express that you are having any trouble with your therapy, we will direct you to a nurse or pharmacist who may give you advice to help you cope.

Open lines of communication
A nurse or pharmacist will call you as often as you need. And we'll stay in touch with your doctor too. If you want, we'll reach out to your doctor on your behalf to express your concerns for you. We can direct you to receive extra emotional support, if needed.

Product integrity
We take care of your medications. Our pharmacists will double check your order to make sure its right before it goes out the door. Our special packaging keeps your medications at the right temperature.

Dependable delivery
We can send your medications by UPS® or FedEx® -- anywhere you want. That includes your home, doctor's office, transplant center, or any other location. We track every package to make sure you get your order safely and on time.

Improvement plans
We look for ways to make our services -- and your experience -- a better one. We might send you surveys so you can tell us how we're doing or how we can improve.

Staying healthy before your transplant 

Stay as active as you can
Keep your muscles as toned as possible right up until your transplant.

Eat well
Work with the nutritionist on your transplant team. Identify the best foods to keep you healthy before your transplant and those foods you should avoid.

Quit smoking
Contact your transplant team for the help you need to cut down and quit before your transplant.

Lose weight if you need to, before your surgery
This will decrease the chances for complications during and after your transplant.

Communicate with your transplant team
If you experience depression, a common problem for people awaiting transplant, talk to your team. They will be able to give you helpful advice for dealing with stress including support groups and anti-depressant medications, if appropriate.

Stay connected with your family and friends
They will be your support as you go through each step of your transplant journey. They will provide you with the help and strength you need to get back your quality of life after the surgery.

The day of your transplant 

The day of your surgery, you will probably feel a little nervous and even a little excited about the procedure. Despite the many questions you may have asked your transplant team, you may still find yourself wondering what that day will be like. Your surgery experience will be unique to you. However, we have included below some of the common things that many transplant recipients have experienced on the day of their transplant.

Timing of your transplant
If you are to receive your transplant from a living donor, your surgery will be scheduled in advance, on a day and time that is most convenient to you, your donor, your doctors, and the transplant center. However, if you are awaiting a cadaver donor, you could be contacted at any time, day or night, to head to the hospital for your transplant.

What you can expect at the hospital
Regardless of whether your transplant is from a living donor or a cadaver donor, you will find yourself in a flurry of activity upon arriving at the hospital.

• The transplant team will take some blood just to double-check compatibility with the donor. They will review your medical history with you one more time. They will also perform a pre-surgical physical exam.
• You will receive tests that may include an EKG, X-rays, and a urine test. Your doctor will also do a cross-matching test that mixes your blood with some of the donor's blood to see how your body will most likely react to the new organ.
• Before surgery, you will be put to sleep with general anesthesia for the duration of the procedure. Some transplants take 3-4 hours, while others can take up to 8-12 hours or more to complete. Length of surgery will depends on the type of transplant being performed as well as the individual complexities of your case. Ask your doctor how long it may take for you.

After your transplant 

When you wake up from your surgery, you will probably feel a little tired, groggy and a bit sore. The actual recovery time will vary based on the type of transplant you received, as well as any complications you may experience during your recovery.

Typically, you can expect to feel the effects of your new organ right away, although certain transplanted organs take longer to gain strength in their new body. To help avoid possible rejection, it is very important to monitor your health during the critical time immediately following the transplant. A transplant is considered major surgery, so you can expect to remain in the hospital for at least one or two weeks following your transplant.

Not taking medications as prescribed is the number one reason for transplant rejections
Your body will recognize your new organ as something that doesn't belong there. If you do not take your anti-rejection medications, your body will build up antibodies in your immune system to fight your new organ. By taking your medication, you will suppress your immune system so that it cannot attack your new organ.

Many of these medications will need to be taken for the rest of your life. This will help to keep you and your new organ healthy.

Your transplant team will clearly explain each of the medications you will need to take, how to take them and why they are important to your health. If you have any questions, ask your transplant team. They will be happy to discuss side effects and possible treatments to help you stay on your medication and keep your new organ healthy.

Vital to your success: monitoring your health
Your transplant team will continuously monitor your health. But you are the best person to judge how well you feel after your transplant. Following the transplant, you will need to check your vital signs and monitor any signs and symptoms you may experience along the way.

Problems are easier to treat when caught early. It is important that you report any abnormalities to your transplant team right away.

• Blood pressure -- Your transplant team will tell you the normal range for your blood pressure. Report unusual changes in your blood pressure, whether high or low, to your transplant team.
• Pulse -- Your pulse measures how many beats your heart makes in one minute. A normal pulse may range between 60-100 beats per minute. Report any major changes in your pulse or if it should go over or below the normal range.
• Temperature -- Take your temperature everyday and immediately if you have chills. Having a fever means you may have an infection and may be in the early stages of rejection. Contact your transplant team if you have a fever of 100.5°F or higher.
• Weight -- You should weigh yourself in the mornings after you use the bathroom but before you eat breakfast. This will help you to notice any sudden weight gain or loss on a daily basis. Weight gain could mean fluid retention, whereas weight loss could be the result of dehydration. Either scenario should be reported immediately to your transplant team so that they can evaluate the cause of your weight change and treat it if necessary.

Signs and symptoms that something may be wrong 

Your body has several ways of letting you know that something may be wrong. Typically, symptoms are those things only you can notice about yourself. Signs are those things that others can recognize about you.

Here are some common symptoms that you may notice. Immediately notify your transplant team if you experience any of the following:

• Pain
• Weakness
• Chills
• Hot flashes
• Nausea
• Nervousness
• Diarrhea
• Cold symptoms

Here are some common signs that you, your family or friends may notice. Immediately notify your transplant team if you become aware of the following:

• Bruises
• A red face
• Jittery hands
• Cuts that are oozing
• White patches in your mouth or throat, etc.
• Staying healthy after your transplant

1. Always take your anti-rejection medications as directed.

2. Have your lab work done as often as your transplant team tells you.

3. Watch yourself for changes in your health, no matter how small, and report them immediately to your transplant team.

4. Ask questions. Your transplant team is there to help you and will do anything in their power to help your transplant be successful.

Find more information about transplants 

Aetna Intelihealth® Website
www.intelihealth.com 

National Marrow Donor Program
3001 Broadway Street Northeast
Suite 100
Minneapolis, MN 55413-1753
Toll Free: 1-800-627-7692 (MARROW2)
www.marrow.org 

United Network for Organ Sharing (UNOS)
P.O. Box 2484
Richmond, VA 23218
Toll Free: 1-888-894-6361
www.unos.org 

National Heart, Lung and Blood Institute (NHLBI)
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: (301) 592-8573
E-Mail: NHLBIinfo@nhlbi.nih.gov
www.nhlbi.nih.gov 

U.S. Department of Health and Human Services
200 Independence Ave., SW
Washington, DC 20201
Toll Free: 1-877-696-6775
www.dhhs.gov 

National Transplant Assistance Fund
150 N. Radnor Chester Road,
Suite F-120
Radnor, PA 19087
Toll Free:Phone: 1-800-642-8399
Fax: 610-535-6106
www.transplantfund.org