Emerging trends in transplantationThoracic transplantationHeart Transplantation for End-Stage Heart Failure Due to Cardiac Sarcoidosis
Section snippets
Methods
We reviewed 19 patients with cardiac sarcoidosis who had end-stage heart failure treated with orthotopic heart transplantation from January 1991 to July 2010. All patients had pathologically proven sarcoidosis after pathologic examination of the explanted heart. The control group consisted of 1,050 patients without cardiac sarcoidosis who received a heart transplant during this same time period. The surgical technique7, 8, 9, 10 and the endomyocardial biopsy protocol11, 12, 13, 14 were
Results
The 19 heart transplant recipients with cardiac sarcoidosis ranged in age from 29 to 68 years, and 10 (53%) were male. Seven patients (37%) had hypertension, 4 (21%) diabetes mellitus type II, and 2 (11%) hyperlipidemia. Eight patients (42%) had known preoperative extracardiac sarcoidosis. Four patients (21%) had biopsy-confirmed cardiac sarcoidosis before transplant, and these patients, as well as the other 15 patients (79%), had cardiac sarcoidosis confirmed with pathologic examination of the
Discussion
Heart transplantation is not universally considered in end-stage heart failure patients with cardiac sarcoidosis, owing to concerns for sarcoid recurrence in the cardiac allograft and possible progression of disease in other organs. We reviewed the outcomes of cardiac transplantation in patients with cardiac sarcoidosis and compared the outcomes in patients without cardiac sarcoidosis who received a heart transplant during a similar time period.
In our study, there was no difference seen in
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