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Published on: July 18, 2014
Heart transplantation outcomes in cardiac sarcoidosis
K C Jackson1, Q R Youmans2, T Wu3
1Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
Insights
Orthotopic heart transplantation (OHT) outcomes for cardiac sarcoidosis (CS) patients are comparable to non-CS patients. This study confirms OHT is a viable treatment option for CS, showing similar survival and graft failure rates.
Area of Science:
- Cardiology
- Transplantation Immunology
- Immunosuppression
Background:
- Cardiac sarcoidosis (CS) is a severe inflammatory heart condition with limited data on transplant outcomes.
- Orthotopic heart transplantation (OHT) is a potential treatment for end-stage heart failure due to CS.
- Understanding OHT outcomes in CS patients is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate and compare Orthotopic Heart Transplantation (OHT) outcomes in patients with Cardiac Sarcoidosis (CS) versus non-CS patients.
- To analyze graft survival, patient survival, graft rejection, infection, and malignancy rates post-OHT.
- To determine the viability of OHT as a treatment for CS.
Main Methods:
- Analysis of 63,947 adult OHT recipients from the United Network for Organ Sharing (UNOS) registry (1987-2019).
- Patients were categorized into Cardiac Sarcoidosis (CS) and non-CS groups.
- Comparison of baseline characteristics and post-transplant outcomes including graft failure, survival, rejection, infection, and malignancy.
Main Results:
- 227 CS patients underwent OHT; they were younger and had higher rates of non-white patients and urgent transplant status.
- Multivariable analysis revealed no significant differences in patient survival (HR 0.86) or graft failure (HR 0.849) between CS and non-CS groups.
- CS patients demonstrated lower odds of graft rejection (OR 0.558) but similar rates of infection and post-transplant malignancy compared to non-CS patients.
Conclusions:
- Orthotopic heart transplantation (OHT) offers comparable survival and graft failure rates for Cardiac Sarcoidosis (CS) patients versus non-CS patients.
- CS patients experienced reduced graft rejection post-OHT.
- Heart transplantation is confirmed as a viable and effective treatment option for patients suffering from CS-related heart failure.
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.
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