Heart transplantation in systemic lupus erythematosus: A case report and meta-analysis

Cardiac involvement in Systemic Lupus Erythematosus can present as end stage heart failure necessitating orthotopic heart transplantation. Most transplant centers regard Lupus as a contraindication to transplant due to risk of disease recurrence in the transplanted organ. Limited reports of heart transplant in Lupus exist in the literature. Herein, we aim to report on the successful transplant and long-term survival of a 24-year-old woman with Lupus and biventricular heart failure. Given the rarity of transplant in Lupus, we also conducted a meta-analysis of reported cases in the literature to assess post-transplant outcomes and evaluate immunosuppression strategies. Our case underlines the feasibility of transplant in Lupus patients, outlines a detailed immunosuppression strategy and favorable long-term outcome to guide centers contemplating such transplants. The long-term survival of our patient, together with review of the thirteen previously described cases, supports that orthotopic heart transplantation can be considered in select patients with Systemic Lupus Erythematosus.