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Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center

Jefferson L Vieira1, Maria G V Sobral1, Francisco Y Macedo2

  • 1Heart Failure Division, Hospital de Messejana Dr Carlos Alberto Studart, Fortaleza, Ceará, Brazil.

Transplantation Direct
|July 1, 2022
PubMed

Insights

Heart transplant survival is similar for patients with Chagas cardiomyopathy (CC) and other heart failure causes. However, survival improvements over time benefit most patients, excluding those with CC, highlighting a need for further research.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Infectious Diseases

Background:

  • Limited data exists on long-term survival after heart transplantation (HT) for patients with Chagas cardiomyopathy (CC).
  • Understanding post-HT outcomes in CC is crucial for improving patient management and prognosis.

Purpose of the Study:

  • To evaluate and compare post-heart transplant survival in patients with Chagas cardiomyopathy versus other etiologies of heart failure.
  • To analyze survival trends across different eras of heart transplantation.

Main Methods:

  • Retrospective cohort study of 376 adult heart transplant recipients (1997-2019).
  • Patients categorized by heart failure etiology: Chagas cardiomyopathy (n=66), nonischemic cardiomyopathy (n=214), ischemic cardiomyopathy (n=96).
  • Analysis stratified by heart transplant era: early (1997-2009), recent (2010-2014), and current (2015-2019).

Main Results:

  • Post-HT survival rates at 1, 5, and 10 years were comparable across etiological groups.
  • Overall 1-year survival improved significantly from 70% in early eras to 80% in the current era.
  • Time-related survival improvements were observed in non-CC patients but not in CC patients after adjustment for covariates.

Conclusions:

  • Posttransplant survival is comparable between Chagas cardiomyopathy and other heart failure etiologies.
  • While overall heart transplant survival has improved, this progress has not extended to patients with Chagas cardiomyopathy.
  • Emphasizes the need for dedicated research, policy development, and a collaborative registry for heart transplantation in Chagas cardiomyopathy.

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