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

                    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
               Referring Physician Listing Notification Letter ............................................................................................ 43






               Updated November 13, 2018                                                                    5
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