An ISHLT Consensus Document for Prevention and Management Strategies for Mechanical Circulatory Support Infection

Published 24 June 2017

Shimon Kusne, MD; Martha Mooney, MD, FACP; Lara Danziger-Isakov, MD, MPH; Annemarie Kaan, MCN, RN; Lars H. Lund, MD, PhD; Haifa Lyster, MSc; Georg Wieselthaler, MD; Saima Aslam, MD, MS; Barbara Cagliostro, RN, MSN; Jonathan Chen, MD; Pamela Combs, PhD, RN; Adam Cochrane, PharmD; Jennifer Conway, MD; Jennifer Cowger, MD, MS; Maria Frigerio, MD; Rochelle Gellatly, PharmD; Paolo Grossi, MD, PhD; Finn Gustafsson, MD, PhD; Margaret Hannan, MD; Angela Lorts, MD; Stanley Martin, MD; Sean Pinney, MD; Fernanda P. Silveira, MD; Stephan Schubert, MD; Stephan Schueler, MD, PhD, FRCS; Martin Strueber, MD; Nir Uriel, MD; Neil Wrightson, RN; Rachel Zabner, MD; Shirish Huprikar, MD

J Heart Lung Transplant. 2017 Oct;36(10):1137-53

• Advanced Lung Failure & Transplantation
• Cardiology
• Cardiothoracic Surgery
• Consensus Document
• Infectious Diseases
• Mechanical Circulatory Support
• Publications & Journals
• Standards & Guidelines

Heart failure remains a major cause of morbidity and mortality. Heart transplantation is a life-saving procedure for patients with advanced heart failure, but availability is limited by donor organ shortage. Durable mechanical circulatory support (MCS) is a major advance in HF management and can provide hemodynamic support until myocardial recovery or HT, or as permanent therapy (destination therapy, DT) for those ineligible for heart transplantation. MCS has continued to enhance patient survival and quality of life through continued improvements in device design and durability. However, MCS infection remains as a major complication and a significant cause of morbidity and mortality in MCS recipients. Furthermore, there is considerable practice variation regarding patient selection for MCS, implant technique, infection prevention strategies anti-microbial prophylaxis, drive-line care and management of infection.

The purpose of this multidisciplinary consensus document is to provide expert consensus-derived recommendations and, whenever possible, evidence-based recommendations for the prevention and management of infection in MCS recipients. This document is the result of a collaboration between the ISHLT and the International Consortium of Circulatory Assist Clinicians (ICCAC), with panel members addressing the epidemiology and microbiology of MCS infections, pre-operative evaluation of the MCS candidate, peri-operative surgical and anti-microbial prophylaxis management, post-operative drive-line management and treatment of MCS infections.

Read at JHLT