Page 40 - Heart Transplant Protocol
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Heart Function Service: Heart Transplant Protocols
Varicella IgM
DIAGNOSTIC STUDIES
CXR AP and Lateral Cardiac Catheterization
ECHO Dependent on Patient Status:
EKG- 15 Lead o Head CT/Head MRI
Abdominal Ultrasound o CT Heart w contrast (all patients with prior
Head Ultrasound (<1yo) sternotomies)
Pulmonary Function Test (age appropriate) o CT of Sinus without contrast
Metabolic Stress Test o Ultrasound of cervical and femoral vessels
Holter Monitor
CONSULTS
CT Surgery Chaplain
Neurology Social Work
Infectious Disease Child Life
Nephrology Palliative Care
Genetics Pharmacy
Nutrition Financial
Psychology Dental Evaluation
PRA Lab Follow-up
Email HLA lab for cPRA Email HLA lab for what to block in UNOS
RECORDS
Immunization Record Developmental/School Records
Social Security Card Outside Hospital Records
All physician as part of patients medical
team confirmed in EPIC
Insurance/Listing
Insurance information given to Financial Verbal Consent to List Patient
Financial Approval Letter for Listing Approval (LOMN)
Consent to Evaluate Family Listing Letter Sent
Candidate Listing
Phoenix initiated Active List updated
Letter to referring physician ABO Protocol initiated if appropriate
Phone call made to referring physician
Updated November 9, 2017 40