Page 48 - Heart Transplant Protocol

Heart Function Service: Heart Transplant Protocols

1. Annual cardiac catheterization, biopsy and angiograms with ECHO, EKG, CXR
2. Transplant Annual labs
4. CMV PCR at 12 months. IgG and IgM with PCR if CMV R –
6. EBV PCR at 12 months
7. HLA antibody profile at 12 months
8. >12 mths Tacrolimus Level Goal (5-8)
9. Every 3 month visit, echo, EKG, Labs

Years 2-5 following transplant:
1. Provider visit every 3 months
a. Echocardiogram and EKG
b. Routine labs
2. EBV PCR yearly, EBV IgG and IgM if past serology negative
3. HLA antibody profile yearly
3. Annual cardiac catheterization, biopsy, angiograms and annual labs
4. Annual CXR or as needed

>5 years following transplant:
1. Provider visit every 3 months
a. Echocardiogram and EKG
b. Routine labs
3. Cardiac catheterization, biopsy and angiograms
4. Annual CXR or as needed
6. EBV PCR yearly, EBV IgG and IgM if past serology negative
7. HLA antibody profile every year
8. Annual Labs

Routine Labs: BNP, CBC with Diff, Lytes, glucose, BUN, Cr, Mg, Phos, Ca, AST, ALT, Bili T&D, Albumin,
Total Protein, Tacrolimus/Cyclosporine/Sirolimus levels (Patient Specific)

Annual Labs:, Routine labs, GGT, LDH, Amylase, Cystatin C, Fasting lipid profile, PT/INR, Vitamin D 25-
OH, Heart Recipient HLA antibody profile. EBV Panel (if previously negative serology), EBV PCR,
Varicella IgG and IgM, HIV, HSV, Hepatitis Panels (A, B & C), RPR, Toxoplasmosis IGG & IGM.
Pneumococcal, Tetanus, and HiB titers. If vaccine boosters given, check titers in 30 days.

Criteria for Allomap testing: > 60 days post-transplant, on < 20 mg steroids, > 10 years of age

Allomap testing could artificially be high with the following: Blood transfusion in last 30 days, treatment
for rejection with steroids in last 21 days and/or steroids >20 mg po daily

Updated November 9, 2017 48