Page 64 - Heart Transplant Protocol

Heart Function Service: Heart Transplant Protocols

Infectious Disease Prophylaxis:

 Antiviral, antibacterial, and antifungal prophylaxis should be initiated while receiving
Thymoglobulin therapy

Contraindications:
 Hypersensitivity to rabbits or rabbit proteins
 Acute viral illness
 History of anaphylaxis with previous Thymoglobulin administration

Adverse Reactions:

 Cardiovascular: Hypertension, peripheral edema, tachycardia
 Central nervous system: Chills, fever, headache, pain, malaise
 Endocrine & metabolic: Hyperkalemia
 Gastrointestinal: Abdominal pain, diarrhea, nausea
 Genitourinary: Urinary tract infection
 Hematologic: Leukopenia, thrombocytopenia
 Neuromuscular & skeletal: Weakness
 Respiratory: Dyspnea
 Miscellaneous: Antirabbit antibody development, sepsis, systemic infection

Drug Interactions:
Thymoglobulin should not be given within 2 months of receiving Varicella or other live vaccines

Monitoring Parameters:
 Vital Signs (Temperature, Pulse, Respiratory rate, Blood pressure) every 15 minutes x2, every 30
minutes x2, then every hour. Treatment can be interrupted abruptly (without a progressive
reduction in the dose)
 Lymphocyte count (total lymphocyte and /or T-cell subset) is recommended daily to assess the
degree of T-cell depletion
 White blood cell (WBC) and platelet counts should also be monitored daily to assess the degree
of neutropenia and thrombocytopenia, respectively
 Serum creatinine levels should be used to evaluate renal function
 Serum electrolytes should be monitored daily

Updated November 9, 2017 64