Poster Abstract Session: Transplants: Infection Epidemiology and Outcome in Solid Organ Transplantation
Saturday, October 29, 2016
Room: Poster Hall
Background: There is a perceived lack of standard practice on IPAC strategies among heart and lung transplant centers.
Methods: A survey was performed of members of the American Society of Transplantation Infectious Diseases Community of Practice in 11/14 and 2/15 on their institutional IPAC policies after heart and lung transplantation.
Results: A total of 40 providers from 29 transplant centers in the United States (22), Canada (2), Switzerland (2), South Korea (1), Ireland (1), and Turkey (1) responded to the survey. Of the 29 centers, only a minority provide HEPA filtered rooms (10.3% immediately post-transplant, and 3.4% when clinically indicated only). Likewise, a minority provide positive pressure rooms (all hospitalizations - 3.4%, immediately post-transplant only -17.2%, when clinically indicated only -10.3%). The number of centers using HEPA filtered or positive pressure rooms did not differ between heart and lung transplant centers. 20.7% of the centers require additional hand hygiene beyond standard handwashing, such as use of gloves (10.3% at all times and 3.4%, immediately post-transplant). Measures beyond standard room cleaning were reported in 17.1% of centers, either immediately post-operatively or with clinical indication. About one third do not use dedicated small medical equipment for use in evaluating heart or lung transplant recipients. Majority of transplant centers does not allow plants or flowers in the units (65%). The majority (68.8%) does not prohibit the use of personal belongings in rooms and the majority does not allow animal companions (63%). Visitor age restriction varied from <5 years to <15 years. Lung transplant centers were more likely to recommend use of respiratory masks for patients when leaving hospital rooms (58%), as compared to heart transplant centers (48%). A third of lung transplant and over a quarter of heart transplant centers recommended respiratory mask use outside of the hospital, however duration varied from immediate post-transplant to at all times.
Conclusion: This survey highlights differences in IPAC strategies among heart and lung transplant centers. Evidence-based guidelines addressing these practices are needed in an effort to standardize the approach in the care of this population.
R. R. Razonable,