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

                    Infection Prophylaxis ........................................................................................................................... 25

                    Monitoring post AMR Treatment: ...................................................................................................... 25
                    Donor specific antibodies Post Transplant ......................................................................................... 26

                  Approach to Rejection Algorithm ........................................................................................................... 27

               Cardiac Allograft Vasculopathy (CAV) Surveillance and Intervention Guideline ........................................ 28
                  Coronary Surveillance Schedule: ............................................................................................................ 28

                  Contributing Factors and Interventions .................................................................................................. 28
                  Classification and Severity of CAV by Angiogram ................................................................................... 28

                  Management ........................................................................................................................................... 29
                  Anticoagulation Following Stents ........................................................................................................... 29

               Hypertension Guideline .............................................................................................................................. 30
                  Immediate Post-Transplant Management .............................................................................................. 30

                  Standard education regarding blood pressure control ........................................................................... 30
               Post-Transplant Infection ............................................................................................................................ 31

                  Prophylaxis .............................................................................................................................................. 31

                    Mycostatin (Nystatin) ......................................................................................................................... 31
                    Trimethoprim/sulfamethoxazole (Bactrim) ........................................................................................ 31

                    Valganciclovir (Valcyte) ....................................................................................................................... 31
                  Guidelines for the management of EBV infection and EBV associated PTLD ......................................... 31

                    Definitions ........................................................................................................................................... 32
                    Major Risk Factors: .............................................................................................................................. 32

                    EBV PCR: .............................................................................................................................................. 32

                    Pretransplant screening: ..................................................................................................................... 32
                    EBV Viral Load Monitoring and Preemptive Therapy ......................................................................... 32

                    Evaluation and management of patients with an elevated EBV PCR will proceed as follows:........... 33
                    Treatment of EBV Disease / PTLD ....................................................................................................... 33

                  Guidelines for CMV Prophylaxis and Management of CMV Infection .................................................... 34
                  Pneumocystis carinii pneumonia (PCP) Prophylaxis Guideline............................................................... 36

               Immunization Guideline .............................................................................................................................. 38
               Heart Transplant Checklist for New Referral .............................................................................................. 39

               Evaluation/Listing Checklist ........................................................................................................................ 40
               Referring Physician Notification Guideline ................................................................................................. 42






               Updated December 14, 2018                                                                    5
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