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Updated: Jun 13, 2026
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
Heart transplantation in patients with amyloidosis
1Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Heart transplantation for amyloid cardiomyopathy is controversial. This study found all patients died of sepsis post-transplant, suggesting it
Area of Science:
- Cardiology
- Transplantation Surgery
Background:
- Cardiac transplantation is a treatment for refractory heart failure.
- Amyloid cardiomyopathy presents challenges for heart transplantation due to donor scarcity and disease recurrence.
Observation:
- A review of heart transplant recipients from 1987-2007 identified 4 patients with amyloid cardiomyopathy.
- No operative mortality occurred, but all patients succumbed to sepsis following transplantation.
Findings:
- Patients with amyloid cardiomyopathy experienced poor outcomes after heart transplantation.
- Sepsis was the cause of death in all reviewed cases post-transplant.
Implications:
- Heart transplantation is not recommended for patients with amyloidosis.
- Enhanced preoperative screening for amyloidosis is crucial in patients with hypertrophic cardiomyopathy.
Abstract:
Cardiac transplantation is currently the only established surgical approach to the treatment of refractory heart failure. Heart transplantation because of amyloid cardiomyopathy continues to generate controversy because of donor shortage and concerns about disease recurrence in the allograft. We reviewed the medical records for all patients who underwent heart transplantation at our institution from 1987 to 2007, and found that 4 patients were diagnosed as having amyloid cardiomyopathy after pathologic examination of the excised hearts. No operative mortality was noted; however, all of the patients died of sepsis after transplantation. Because of the poor results, we do not recommended performing transplantation in patients with amyloidosis. Preoperative surveys and evaluation for amyloidosis must be emphasized in patients with hypertrophic cardiomyopathy.
