4. Clinical Guidelines for Liver Transplantation (PDF) - British ...

Guidebook for the Solid Organ Transplant Programme Chapter 4
Appendix G
VANCOUVER HOSPITAL & HEALTH SCIENCES CENTER
DOCTOR’S ORDERS
STANDING LAB ORDERS FOR LIVER TRANSPLANT PROGRAM
Date:
Full BLOOD WORK
CBC with differential
PTT, INR
Na, K, C1, PO4, Mg, Ca, CO 2
BUN, Cr, Glucose (random), uric acid,
Total/direct bilirubin, Alk. phosphatase, GGT, AST, ALT
Amylase, albumin, total protein
Cyclosporine level, Sirolimus level or FK506 (Tacrolimus) level
Mini BLOOD WORK
CBC with differential
PTT, INR
K, BUN, Cr,
Total/direct bilirubin, Alk. phosphatase, GGT, AST, ALT
Cyclosporine level, Sirolimus level or FK506 (Tacrolimus) level
ANNUAL BLOOD WORK
Same as full blood work plus the following tests:
HgAIC:
Done at 3 months post transplant.
If the values are abnormal and/or diabetic patient, repeat q 3 months and consult doctor.
If the values are normal, then annually thereafter.
Lipid studies: (Cholesterol, triglycerides, HDL, LDL):
Done at 6 months and annually thereafter.
If the values are elevated, follow level and consult doctor.
Hepatitis Screening:
Done at 1 year post-transplant and as ordered thereafter.
Hepatitis B positive patient/or donor: HBV DNA, HCV Ab
*HBV DNA annually thereafter.
Hepatitis C positive patient: HBsAg, HBc Ab(total)
Non Hep B & Hep C: HBsAg, HBc Ab(total), HCV Ab
AFP test: Every 4 months x 3 years and annually thereafter on patient who has any one of the
following conditions: Hep B, Hep C and/or malignancy.
CA19to9: Every 4 months x 3 years and annually thereafter on patient who has gallbladder
malignancy.
Abdominal ultrasound with Doppler
____________________
Physician Signature
________________________________
Printed Name/PIC
Chapter 4 – Clinical Guidelines for Liver Transplantation – July, 2010 Page 48
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