Related Experiment Video
Updated: Jan 13, 2026
A Modified Cuff Technique for Mouse Cervical Heterotopic Heart Transplantation Model
Published on: February 7, 2022
Heart Transplantation in Patients With Systemic Sclerosis
Morgan D Smith1, Miroslav Sekulic2, Matthew Regan1
1Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA.
Insights
Heart transplant (HT) in systemic sclerosis (SSc) patients shows good mid-term graft function. Despite increased rejection rates, HT is feasible for carefully selected SSc patients with advanced heart failure.
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.
Introduction:
Systemic sclerosis (SSc) is a multisystem disease, frequently leading to heart failure (HF). Heart transplant (HT) remains the definitive therapy for advanced HF, but HT outcomes in SSc patients remain poorly characterized. This study aims to report the outcomes of HT in patients with SSc.
Methods:
A retrospective analysis of all HT recipients with SSc between 2007 and 2024 at two transplant centers. Baseline characteristics, index admission, and post HT outcomes were captured from the electronic medical record. Pathology of explants and allograft biopsies was read by a dedicated pathologist.
Results:
Seven of 1153 patients who received HT had SSc. Six of these received HT alone, while one received a heart-lung transplant. Five (71%) were waitlist status 2 at the time of transplant. Median age was 52, and five patients (71%) were male. Pathologic examination of the seven patients' explanted native hearts showed that two (29%) had active inflammation, six (86%) had fibrosis, and four (57%) had vascular remodeling. With a median follow-up of 3.2 years (range: 1.0-18.2) post-HT, six patients (86%) had a preserved ejection fraction at last assessment, while one suffered graft failure due to acute cellular (ACR) and antibody-mediated rejection (AMR). Two patients (29%) developed 2R ACR (range: 0-1 months), and two (29%) developed AMR (range: 4-5 years). Post-HT, one patient developed gastroparesis due to SSc, and one required a renal transplant due to complications of immunosuppression.
Conclusions:
HT in SSc patients demonstrates good mid-term graft function despite an increased incidence of rejection, supporting feasibility in carefully selected candidates.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy