ISHLT Consensus Document for MCS Infection Prevention and Management

An ISHLT consensus document for prevention and management strategies for mechanical circulatory support infection” was published in The Journal of Heart and Lung Transplantation in June of 2017. This important document sought to reduce practice variation regarding patient selection for durable mechanical circulatory support (MCS), implant technique, infection prevention strategies anti-microbial prophylaxis, drive-line care and management of infection. 

Experts from around the world collaborated to establish key principles for infection prevention, diagnosis, and management for all implantable and paracorporeal durable MCS devices with percutaneous drive-lines or cannulas, including pulsating and continuous-flow devices. It’s important to note that there were no distinctions in infection prevention between these devices and differences in infection rates and outcomes were unaccounted for.

Lara Danziger-Isakov of Cincinnati Children’s Hospital Medical Center is paving the way to adapt these guidelines to children, leading ACTION’s VAD & MCS Infection Committee with Allison Reichhold of Lurie Children’s Hospital of Chicago. The committee has introduced guidelines to reduce infection rates after MCS, such as new driveline infection prevention protocols. 

ACTION provides the opportunity and network to develop, implement and evaluate the options to prevent and manage infections in pediatric MCS/VAD patients. Without this network, the further development of guidance in this arena will continue to be insufficient to improve outcomes in this vulnerable patient population.

Other ACTION leaders/members that contributed to this ISHLT document include:

  • Jennifer Conway, Stollery Children’s Hospital
  • Angela Lorts, Cincinnati Children’s Hospital Medical Center

Chen S, Cantor RS, Auerbach S, Schumacher K, Almond CS, Eghtesady P, Alejos J, Das BB, Hong BJ, Jaquiss RDB, Kirklin JK, Jeewa A. Outcomes After Infections in Adolescents and Young Adults with Continuous-Flow Left Ventricular Assist Devices. ASAIO J. 2019 May/Jun;65(4):380-388. doi: 10.1097/MAT.0000000000000816. PMID: 29762230.