Heart Transplantation Outcomes in Cardiac Sarcoidosis

2021 
Abstract 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 CS patients 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-squared 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 CS patients underwent OHT. CS patients 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 CS and Non-CS patients. CS patients had lower odds of rejection (OR 0.558, CI 0.315- 0.985, p= 0.0444). CS patients had similar odds of hospitalization for infection and post-transplant malignancy, as Non-CS patients. Conclusion CS and Non-CS patients 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 CS patients.
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