Abstract 18826: Excellent Outcomes in Long-Term Follow-Up After Heart Transplantation for Cardiac Sarcoidosis
Introduction: Orthotopic heart transplant (OHT) is increasingly utilized for end-stage heart failure due to cardiac sarcoidosis (CS). However, concern regarding the long-term outcomes in CS patients undergoing OHT persists, due to concurrent lung and systemic disease.
Hypothesis: We hypothesized no difference in pulmonary hemodynamics, incidence of allograft rejection, or mortality between OHT patients with CS and without CS.
Methods: We compared 12 post-OHT patients with CS and 28 age-matched post-OHT patients due to non-ischemic cardiomyopathy (non-CS group). Baseline demographics and invasive hemodynamic parameters were measured immediately after OHT, one week post-OHT, and in routine follow-up. Primary endpoints were changes in pulmonary artery pressures, right ventricular stroke work index (RVSWI), and pulmonary compliance. Secondary endpoints included rate and degree of allograft rejection and death.
Results: During a mean follow-up of 73.8 months, changes in invasive hemodynamics between 1 week and most recent follow-up for CS compared to non-CS patients showed no difference in right atrial or pulmonary pressures, RVSWI, or cardiac index. Although there was a statistically significant change in SVR (p=0.006) and PVR (p=0.002) in CS patients compared to non-CS, the magnitude of difference was not clinically relevant. Incidence of grade ≥ 1a rejection (17% vs. 68%, p=0.006) was less in the CS group, and 0/12 patients in the CS group experienced histologic or clinical recurrence of sarcoidosis or ≥2 rejection during the study period.
Conclusions: During long-term follow-up, CS patients had excellent survival post-OHT, with 0 deaths and no significant rejection at a mean follow-up of 6.1 years. CS patients have similar post-transplant hemodynamics as non-CS patients without evidence of RV dysfunction or pulmonary hypertension.
Author Disclosures: D.G. Rosenthal: Research Grant; Modest; AMA Foundation Seed Grant. M.E. Anderson: None. B.J. Petek: None. D.M. Arnett: None. Z.D. Goldberger: None. K.K. Patton: None. R.K. Cheng: None.
- © 2016 by American Heart Association, Inc.