Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Cardiac sarcoidosis (CS) is a known etiology of end-stage dilated, hypertrophic, or arrhythmogenic cardiomyopathies requiring heart transplantation (HT). We sought to evaluate the long-term post-HT outcomes of patients with CS compared to patients without CS.
*Methods: A retrospective analysis of 63,142 HT patients from the United Network Organ Sharing (UNOS) registry from 1987 to 2019 was undertaken. Comparisons between patient characteristics of HT recipients with CS (N=288) and those without a diagnosis of CS (N=62,854) were made using standard statistical methods using Cox proportional hazards regression for survival analysis.
*Results: HT recipients with CS were more likely to be older (52.4 ± 9.0 vs 46.6 ± 19.2, p<0.001) and female (35.8% vs 26.2%, p<0.001). They were less likely to be smokers (24.7% vs 33.1%, p=0.002), to have diabetes (15.4% vs 20.6%, p=0.03), and to have undergone prior non-transplant cardiac surgery (12.2% vs 18.3%, p=0.01). In terms of transplant-related factors, sarcoid HT recipients more often received an older donor (32.1 ± 11.8 vs 28.2 ± 14.0, p<0.001) but had similar ischemic times and life support requirements at time of transplant. Prior to HT, the CS patients were less likely to require mechanical ventilation (0.3% vs 4.3%, p = 0.001) but had similar rate of ventricular assist device and extracorporeal membrane oxygenation requirements. Median time on the wait list was similar between CS and non-CS groups. There was significantly lower overall post-transplant mortality in the sarcoid HT recipients in the 150 months follow-up period (p<0.001).
*Conclusions: Cardiac sarcoidosis HT recipients are more likely to be older but have less underlying co-morbidities such as diabetes, smoking, and prior cardiac surgery. CS patients’ peri-operative acuity is similar to the non-CS end stage heart failure patients. However, they have improved long-term survival post-HT compared to the non-CS post-HT population. These findings suggest that clinicians should have a low threshold for diagnostic testing and work-up if cardiac sarcoidosis is suspected.
To cite this abstract in AMA style:Liu GS, DePasquale EC, Wolfson AM, Chand RR, Banankhah P, Nattiv J, Salimbangon AD, Genyk PA, Kingsford PA, Li JP, Vucicevic D, Pandya K, Rahman J, Fong M, Vaidya AS. Post Heart Transplant Outcomes for Patients with Cardiac Sarcoidosis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/post-heart-transplant-outcomes-for-patients-with-cardiac-sarcoidosis/. Accessed October 21, 2020.
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