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Patient handout

ADHF in cardiac transplant recipient (CAV / ACR / AMR)

PRODUCTION

1. Your condition

This handout is for adhf in cardiac transplant recipient (cav / acr / amr). Your care team identified this based on: heart transplant recipient with new dyspnea / orthopnea / edema (concern for rejection or cav).

Other reasons your team may use this plan: unexplained troponin or bnp rise in transplant recipient (rejection screen); new lvef reduction on surveillance echo in transplant recipient; positive donor-specific antibody (dsa) titer + clinical decompensation → amr concern.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
methylprednisolone1000 mg IV daily × 3 days (pulse therapy)IVdaily × 3ISHLT 2010 (Stewart PMID 21177015) — pulse steroids first line for ≥2R ACR; also adjunct in AMR
mycophenolate mofetil1000–1500 mg PO BID (continue maintenance; do not hold for rejection)POBIDISHLT 2023 maintenance triple therapy (CNI + MMF + steroids); continue during rejection treatment
tacrolimusMaintain trough 8–12 ng/mL early post-transplant; 5–10 ng/mL late; AVOID over-reductionPOBIDKDIGO transplant 2009 — narrow therapeutic window; sub-therapeutic trough is the most modifiable rejection driver
rituximab375 mg/m² IV weekly × 4IVweekly × 4AMR B-cell depletion; ISHLT 2013 AMR working formulation
immune globulin (IVIG)1–2 g/kg IV (split over 2–5 days)IVone course (often combined with plasmapheresis)AMR neutralization of circulating DSA; combined with plasmapheresis per ISHLT 2013
torsemide20–40 mg IV/POIV/POdaily–BIDDecongestion; preferred over furosemide if gut edema (TRANSFORM-HF Mentz JAMA 2023); avoid NSAIDs

Plan: Cardiac transplant ADHF — rejection / CAV phenotype-based regimen (ISHLT 2010 + 2023; KDIGO transplant 2009)

3. When to call your provider

Contact your care team if any of the following happen:

  • New LV dysfunction → STAT biopsy + DSA
  • CAV ISHLT 3 progression → re-transplant evaluation
  • PTLD suspicion → reduce immunosuppression + oncology consult

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • Endomyocardial biopsy pAMR2 or pAMR3 + DSA positive + new heart pumping strength (LVEF) reduction(life-threatening)
  • ISHLT 2010 grade 3R ACR (severe acute cellular rejection with myocyte damage)(life-threatening)
  • Cardiac allograft vasculopathy ISHLT grade 3 (severe distal pruning + heart pumping strength (LVEF) <45) on annual surveillance
  • Tacrolimus trough <5 ng/mL early or <4 ng/mL late + biopsy-proven active rejection
  • Transplant recipient with SBP <90 + lactate ≥2 + new severe LV/RV dysfunction (graft failure)(life-threatening)

6. Sources

Guideline: ISHLT 2010 ACR grading + ISHLT 2013 AMR working formulation + ISHLT 2023 update + KDIGO transplant 2009

  1. pubmed.ncbi.nlm.nih.gov/21177015
  2. pubmed.ncbi.nlm.nih.gov/23446352
  3. pubmed.ncbi.nlm.nih.gov/25997674