BACKGROUND: Controversy exists whether heart transplantation (HTx) is an appropriate treatment option for patients with cardiac sarcoidosis due to its potential recurrence and multi-organ involvement. Recent data from the United Network for Organ Sharing dataset suggest that the clinical outcome of cardiac sarcoidosis patients is equivalent or even better than that of the general HTx population. METHODS: We retrospectively reviewed the clinical course of 14 patients with cardiac sarcoidosis among a total of 825 patients who underwent HTx at Columbia University Medical Center between 1997 and 2010. Post-transplant survival of patients with sarcoidosis was compared with that of non-sarcoidosis patients. RESULTS: More than half of cardiac sarcoidosis patients were initially diagnosed after HTx by tissue analysis of the explanted heart. While only 2/14 cases showed recurrence of cardiac sarcoidosis, the clinical outcome of sarcoid patients showed a trend toward higher mortality than that of non-sarcoidosis patients following HTx (1- and 5-year survival, 78.5 versus 87.2%, 52.4 versus 76.2%, respectively, p=0.09). CONCLUSIONS: Although this is a single-center, retrospective analysis of a small number of cardiac sarcoidosis patients who underwent HTx, a concerning trend toward a higher mortality of patients with cardiac sarcoidosis was noted. A careful candidate selection in patients with known cardiac sarcoidosis should be discussed.
BACKGROUND: Controversy exists whether heart transplantation (HTx) is an appropriate treatment option for patients with cardiac sarcoidosis due to its potential recurrence and multi-organ involvement. Recent data from the United Network for Organ Sharing dataset suggest that the clinical outcome of cardiac sarcoidosispatients is equivalent or even better than that of the general HTx population. METHODS: We retrospectively reviewed the clinical course of 14 patients with cardiac sarcoidosis among a total of 825 patients who underwent HTx at Columbia University Medical Center between 1997 and 2010. Post-transplant survival of patients with sarcoidosis was compared with that of non-sarcoidosispatients. RESULTS: More than half of cardiac sarcoidosispatients were initially diagnosed after HTx by tissue analysis of the explanted heart. While only 2/14 cases showed recurrence of cardiac sarcoidosis, the clinical outcome of sarcoidpatients showed a trend toward higher mortality than that of non-sarcoidosispatients following HTx (1- and 5-year survival, 78.5 versus 87.2%, 52.4 versus 76.2%, respectively, p=0.09). CONCLUSIONS: Although this is a single-center, retrospective analysis of a small number of cardiac sarcoidosispatients who underwent HTx, a concerning trend toward a higher mortality of patients with cardiac sarcoidosis was noted. A careful candidate selection in patients with known cardiac sarcoidosis should be discussed.
Authors: Sanjay Divakaran; Garrick C Stewart; Neal K Lakdawala; Robert F Padera; Wunan Zhou; Akshay S Desai; Michael M Givertz; Mandeep R Mehra; Raymond Y Kwong; Sandeep S Hedgire; Brian B Ghoshhajra; Viviany R Taqueti; Hicham Skali; Sharmila Dorbala; Ron Blankstein; Marcelo F Di Carli Journal: Circ Cardiovasc Imaging Date: 2019-06-10 Impact factor: 7.792
Authors: Eileen M Hsich; Joseph G Rogers; Dennis M McNamara; David O Taylor; Randall C Starling; Eugene H Blackstone; Jesse D Schold Journal: JACC Heart Fail Date: 2016-05-11 Impact factor: 12.035
Authors: Joseph P Lynch; Jennifer Hwang; Jason Bradfield; Michael Fishbein; Kalyanam Shivkumar; Roderick Tung Journal: Semin Respir Crit Care Med Date: 2014-07-09 Impact factor: 3.119
Authors: Nisha A Gilotra; Jan M Griffin; Noelle Pavlovic; Brian A Houston; Jessica Chasler; Colleen Goetz; Jonathan Chrispin; Michelle Sharp; Edward K Kasper; Edward S Chen; Ron Blankstein; Leslie T Cooper; Emer Joyce; Farooq H Sheikh Journal: J Card Fail Date: 2021-07-11 Impact factor: 5.712