Management of Cardiac Sarcoidosis after Orthotopic Heart Transplant: A Multi-Institutional Experience

Purpose Cardiac sarcoidosis (CS) is a chronic granulomatous disease of uncertain etiology that has the potential to recur in transplanted hearts. Practice guidelines outlining the optimal care of CS patients do not currently exist for heart transplant recipients. We therefore conducted an online survey of heart transplant providers to gain insight into current practice patterns. Methods An online survey was distributed to members of the International Society for Heart and Lung Transplantation. It consisted of 16 questions designed to classify provider type, location and management preferences. Differences between groups were analyzed for significance using Chi-square and/or Fisher exact tests. Results 82 providers from 49 different transplant centers responded to our survey. Among respondents, 56 (69%) were cardiologists, 11 (13.1%) advanced practice providers, and 3 (3.6%) surgeons. A significantly greater percentage of centers maintained their CS versus non-CS patients on lifelong prednisone (58.2% vs 4.9%, p Conclusion A significantly greater proportion of CS patients are maintained on lifelong prednisone post-OHT compared to non-CS patients. For routine monitoring of CS recurrence, cardiac MRI and PET appear to be the preferred modalities for assessing CS recurrence in the allograft. However, a significant percentage of providers do not routinely monitor for CS recurrence post-OHT.