Page 5 - Heart Transplant Guidelines
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Heart Function Service: Heart Transplant Guidelines

               Cardiac Allograft Vasculopathy (CAV) Surveillance and Intervention Guideline ........................................ 27

                  Coronary Surveillance Schedule: ............................................................................................................ 27
                  Contributing Factors and Interventions .................................................................................................. 27

                  Classification and Severity of CAV by Angiogram ................................................................................... 27

                  Management ........................................................................................................................................... 28
                  Anticoagulation Following Stents ........................................................................................................... 28

               Hypertension Guideline .............................................................................................................................. 29
                  Immediate Post-Transplant Management .............................................................................................. 29

                  Standard education regarding blood pressure control ........................................................................... 29
               Post-Transplant Infection ............................................................................................................................ 30

                  Prophylaxis .............................................................................................................................................. 30
                    Mycostatin (Nystatin) ......................................................................................................................... 30

                    Trimethoprim/sulfamethoxazole (Bactrim) ........................................................................................ 30
                    Valganciclovir (Valcyte) ....................................................................................................................... 30

                  Guidelines for the management of EBV infection and EBV associated PTLD ......................................... 30

                    Definitions ........................................................................................................................................... 31
                    Major Risk Factors: .............................................................................................................................. 31

                    EBV PCR: .............................................................................................................................................. 31
                    Pretransplant screening: ..................................................................................................................... 31

                    EBV Viral Load Monitoring and Preemptive Therapy ......................................................................... 31
                    Evaluation and management of patients with an elevated EBV PCR will proceed as follows:........... 32

                    Treatment of EBV Disease / PTLD ....................................................................................................... 32

                  Guidelines for CMV Prophylaxis and Management of CMV Infection .................................................... 33
                  Pneumocystis carinii pneumonia (PCP) Prophylaxis Guideline............................................................... 35

               Immunization Guideline .............................................................................................................................. 37
               Heart Transplant Checklist for New Referral .............................................................................................. 38

               Evaluation/Listing Checklist ........................................................................................................................ 39
               Referring Physician Notification Guideline ................................................................................................. 41

               Referring Physician Listing Notification Letter ............................................................................................ 42
               Outpatient Follow-up .................................................................................................................................. 43

                  Pre-transplant Outpatient Follow-up Guidelines.................................................................................... 43
                    Listed Status 1A: VAD Patient ............................................................................................................. 43






               Updated May 17, 2018                                                                         5
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