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Double organ transplantation in cardiac amyloidosis
Aggeliki Gkouziouta1, Dimitrios Farmakis, Athanassios Manginas
1aOnassis Cardiac Surgery Center bSecond Department of Cardiology, Attikon University Hospital cFirst Department of Internal Medicine, Laiko Hospital dDepartment of Cardiology, Mediterraneo Hospital, Athens, Greece.
Insights
Mechanical circulatory support can help patients with cardiac amyloidosis (AL) survive heart transplantation. This case study shows a patient
Area of Science:
- Cardiology
- Transplantation Medicine
- Cardiomyopathy Research
Background:
- Cardiac amyloidosis, specifically AL amyloidosis, is the leading infiltrative cardiomyopathy.
- This condition carries a poor prognosis, with high mortality rates.
- Outcomes for cardiac transplantation are generally unfavorable, with significant waiting list mortality.
Background:
Cardiac amyloidosis, particularly primary or AL amyloidosis, is the most common infiltrative cardiomyopathy and is associated with a poor prognosis. The outcome of cardiac transplantation is generally poor, and almost half of patients die while waiting for the procedure to be done.
Patient:
We report here the remarkable case of a 63-year-old man with heart failure caused by AL amyloidosis. After a long course, which included rapid deterioration of preexisting heart failure, cardiac arrest, cardiogenic shock, biventricular assist device support, heart transplantation, renal failure, kidney transplantation and finally a life-threatening H1N1 virus pneumonia, the patient managed not only to survive but also to return fully to his previous demanding duties and lifestyle.
Discussion:
Early use of left ventricular or biventricular mechanical circulatory support may be beneficial as a bridge to transplantation in patients with cardiac AL amyloidosis.
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