Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation

Area of Science:

• Cardiology
• Transplantation Medicine
• Cardiomyopathy Research

Background:

• Cardiac amyloidosis is a progressive disease causing heart failure and mortality.
• Historically, heart transplantation outcomes were poorer for amyloidosis due to its systemic nature.
• Contemporary therapies and patient selection may improve outcomes for cardiac amyloidosis patients undergoing transplantation.

Purpose of the Study:

• To evaluate heart transplantation outcomes in patients with cardiac amyloidosis.
• To compare these outcomes with the general heart transplantation population at a single center.

Main Methods:

• Retrospective analysis of 31 cardiac amyloidosis patients undergoing heart transplantation (2004-2017).
• Comparison of pre-transplantation characteristics and post-transplantation outcomes.
• Stratification by amyloidosis type: light chain amyloidosis and transthyretin amyloidosis (ATTR).

Main Results:

• ATTR amyloidosis patients were older, more male, with worse renal function and longer wait times.
• No significant differences in post-operative complications (bleeding, renal failure, infection, rejection, malignancy) were observed.
• Mortality rates were comparable between cardiac amyloidosis patients and those transplanted for other heart failure causes.

Conclusions:

• Heart transplantation is a viable therapeutic option for carefully selected cardiac amyloidosis patients.
• Outcomes after heart transplantation for cardiac amyloidosis are similar to those for other etiologies of heart failure.