Heart Transplantation in Patients With Systemic Sclerosis

Area of Science:

• Cardiology
• Transplantation Medicine
• Rheumatology

Background:

• Systemic sclerosis (SSc) is a multisystem disease often leading to heart failure (HF).
• Heart transplant (HT) is the definitive treatment for advanced HF.
• Outcomes of HT in SSc patients are not well-characterized.

Purpose of the Study:

• To report the outcomes of heart transplant (HT) in patients with systemic sclerosis (SSc).

Main Methods:

• Retrospective analysis of HT recipients with SSc from 2007-2024 at two transplant centers.
• Collected baseline characteristics, admission data, and post-HT outcomes from electronic medical records.
• Pathology of explanted hearts and allograft biopsies reviewed by a dedicated pathologist.

Main Results:

• Seven SSc patients underwent HT (six heart-only, one heart-lung).
• Median follow-up was 3.2 years; 86% had preserved ejection fraction.
• Incidence of rejection included acute cellular rejection (ACR) and antibody-mediated rejection (AMR); one patient experienced graft failure.

Conclusions:

• Heart transplant (HT) in SSc patients demonstrates good mid-term graft function.
• An increased incidence of rejection was observed.
• HT is feasible in carefully selected SSc candidates with advanced heart failure.