Page 5 - Heart Transplant Protocol
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Heart Function Service: Heart Transplant Protocols

                  Surveillance ............................................................................................................................................. 27

                  Contributing Factors and Interventions .................................................................................................. 27
                  Classification and Severity of CAV by Angiogram ................................................................................... 27

                  Management ........................................................................................................................................... 28

                  Anticoagulation Following Stents ........................................................................................................... 28
               Hypertension Protocol ................................................................................................................................ 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
                  Protocols 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

                  Protocols for CMV Prophylaxis and Management of CMV Infection ..................................................... 33

                  Pneumocystis carinii pneumonia (PCP) Prophylaxis Protocol ................................................................ 35
               Immunization Protocol ............................................................................................................................... 37

               Heart Transplant Checklist for New Referral .............................................................................................. 38
               Evaluation/Listing Checklist ........................................................................................................................ 39

               Referring Physician Notification Protocol ................................................................................................... 41
               Referring Physician Listing Notification Letter ............................................................................................ 42

               Outpatient Follow-up .................................................................................................................................. 43
                  Pre-transplant Outpatient Follow-up Protocols ..................................................................................... 43

                    Listed Status 1A: VAD Patient ............................................................................................................. 43
                    Listed Status 1B ................................................................................................................................... 43






               Updated February 27, 2018                                                                    5
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