Background

Cardiac sarcoidosis (CS) is a progressive inflammatory cardiomyopathy that can lead to heart failure, arrhythmia, and death. There is limited data on Orthotopic Heart Transplantation (OHT) outcomes in patients with CS. Here we examine outcomes in patients with CS who have undergone OHT at centers throughout the United States from 1987 to 2019.

Methods

This was an analysis of 63,947 adult patients undergoing OHT captured in the United Network for Organ Sharing (UNOS) registry. Patients were characterized as cardiac sarcoidosis (CS) or Non–CS. Baseline characteristics were compared using chi-square and Kruskal-Wallis Tests. Outcomes of interest included primary graft failure, patient survival, treated graft rejection, hospitalization for infection, and post-transplant malignancy.

Results

During the study period 227 patients with CS underwent OHT. Patients with CS were younger, had higher proportion of non–white patients, and received transplants at more urgent statuses. After multivariable modeling there was no difference in survival (HR 0.86, CI 0.59-1.3, p = 0.446) or graft failure (HR 0.849, CI 0.58-1.23, p = 0.394) between patients with CS and Non–CS. Patients with CS had lower odds of rejection (OR 0.558, CI 0.315- 0.985, p = 0.0444). Patients with CS had similar odds of hospitalization for infection and post-transplant malignancy, as Non–CS patients.

Conclusions

Patients with CS and Non–CS had similar post OHT survival, odds of graft failure, hospitalizations for infection, and post-transplant malignancy. Results of this study confirm the role of heart transplantation as a viable option for patients with CS.

中文翻译：

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心脏结节病的心脏移植结局

背景

心脏结节病 (CS) 是一种进行性炎症性心肌病，可导致心力衰竭、心律失常和死亡。关于CS 患者原位心脏移植 (OHT) 结局的数据有限。在这里，我们检查了 1987 年至 2019 年在美国各地中心接受过 OHT 的 CS 患者的结果。

方法

这是对器官共享联合网络 (UNOS) 登记中捕获的 63,947 名接受 OHT 的成年患者的分析。患者被表征为心脏结节病（CS）或非CS。使用卡方检验和 Kruskal-Wallis 检验比较基线特征。感兴趣的结果包括原发性移植失败、患者存活、治疗的移植排斥、感染住院和移植后恶性肿瘤。

结果

在研究期间，227 名 CS 患者接受了 OHT。CS患者更年轻，非白人患者比例更高，并且在更紧急的状态下接受了移植。在多变量建模后，CS 和非 CS 患者的生存率（HR 0.86，CI 0.59-1.3，p = 0.446）或移植失败（HR 0.849，CI 0.58-1.23，p = 0.394）没有差异。CS 患者的排斥几率较低（OR 0.558，CI 0.315-0.985，p = 0.0444）。CS 患者因感染和移植后恶性肿瘤住院的几率与非 CS 患者相似。

结论

CS 和非 CS 患者在 OHT 后生存率、移植失败几率、因感染住院和移植后恶性肿瘤方面相似。这项研究的结果证实了心脏移植作为 CS 患者可行选择的作用。