Page 5 - Heart Transplant Guidelines

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