Background
Cardiac sarcoidosis (CS) is a progressive inflammatory cardiomyopathy that can lead
to heart failure, arrhythmia, and death. There is limited data on Orthotopic Heart
Transplantation (OHT) outcomes in patients with CS. Here we examine outcomes in patients
with CS who have undergone OHT at centers throughout the United States from 1987 to
2019.
Methods
This was an analysis of 63,947 adult patients undergoing OHT captured in the United
Network for Organ Sharing (UNOS) registry. Patients were characterized as cardiac
sarcoidosis (CS) or Non–CS. Baseline characteristics were compared using chi-square
and Kruskal-Wallis Tests. Outcomes of interest included primary graft failure, patient
survival, treated graft rejection, hospitalization for infection, and post-transplant
malignancy.
Results
During the study period 227 patients with CS underwent OHT. Patients with CS were
younger, had higher proportion of non–white patients, and received transplants at
more urgent statuses. After multivariable modeling there was no difference in survival
(HR 0.86, CI 0.59-1.3, p = 0.446) or graft failure (HR 0.849, CI 0.58-1.23, p = 0.394) between patients with CS and Non–CS. Patients with CS had lower odds of rejection
(OR 0.558, CI 0.315- 0.985, p = 0.0444). Patients with CS had similar odds of hospitalization for infection and post-transplant
malignancy, as Non–CS patients.
Conclusions
Patients with CS and Non–CS had similar post OHT survival, odds of graft failure,
hospitalizations for infection, and post-transplant malignancy. Results of this study
confirm the role of heart transplantation as a viable option for patients with CS.
Keywords
Abbreviations:
AV (atrioventricular), CS (cardiac sarcoidosis), GDMT (guideline directed medical therapy), IABP (intra-aortic balloon pump), MCSD (mechanical circulatory support device), OHT (orthotopic heart transplantation), PPM (permanent pacemaker), UNOS (United Network for Organ Sharing)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 30, 2021
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© 2021 International Society for Heart and Lung Transplantation. All rights reserved.
