Abstract 13688: Patients With Autoimmune Disease: Not a Contraindication for Heart Transplantation
Introduction: Autoimmune diseases such as lupus, scleroderma, sarcoidosis, and psoriasis are associated with an increased immune response through autoantibody formation.There has been concern that this up-regulation of the immune system may increase the risk of rejection after heart transplantation. Therefore, we evaluated our patients with autoimmune diseases who subsequently underwent heart transplantation at our institution.
Methods: Between 2009 and 2013 we assessed 26 patients who had a concomitant history of autoimmune disease prior to heart transplantation. Autoimmune diseases included psoriasis (5), Grave’s disease (5), sarcoidosis (5), CREST syndrome (2), Hashimoto thyroiditis (1), dermatomyositis (1), ulcerative colitis (1), systemic lupus erythematosus (1), multiple sclerosis (1), antiphospholipid syndrome (1), polymyalgia rheumatic (1), celiac disease (1), and ANCA vasculitis (1). These patients were compared to a control group of patients who did not have pre-transplant autoimmune disease (n=363).
Results: Patients with pre-transplant autoimmune disease did not have any significant difference in 1- year survival, 1-year actuarial freedom from any treated rejection, 1-year actuarial freedom from treated cellular rejection, 1- year actuarial freedom from treated antibody- mediated rejection, and 1-year actuarial freedom from biopsy negative rejection (see table).
Conclusions: Pre-transplant autoimmune diseases do not appear to affect post-transplant outcomes. Therefore, preexisting autoimmune disease is not a contraindication to proceed with heart transplant.
Author Disclosures: J. Yabuno: None. J. Patel: Research Grant; Modest; Alexion Pharmaceuticals. M. Kittleson: None. M. Luu: None. F. Liou: None. S. Siddiqui: None. D.H. Chang: Research Grant; Modest; TEVA pharmaceutical industries LTD. Other; Modest; Stock in AbbVie, Stock in Abbott Vascular. L. Czer: Research Grant; Modest; St. Jude Medical. M. Hamilton: Speakers Bureau; Modest; Abbott-Vascular. J.A. Kobashigawa: Research Grant; Modest; Novartis, CareDx. Consultant/Advisory Board; Modest; Novartis, TransMedics.
- © 2015 by American Heart Association, Inc.