Heart transplantation for cardiac amyloidosis: successful one-year outcome despite recurrence of the disease.
Systemic amyloidosis has been considered a theoretical contraindication for heart transplantation because of the concern that amyloidosis is a systemic disease that could potentially recur in the allograft. To date, no patients have been reported to have undergone heart transplantation. One year ago a patient with amyloidosis had a transplantation at the Oregon Health Sciences University, Portland. Results of kidney, rectal, and bone marrow biopsies were normal; however, endomyocardial and gingival biopsies showed positive results for amyloidosis. Recurrence of amyloidosis was detected by electron microscopy 14 weeks after transplantation; however, light microscopy has not shown any amyloidosis at 1 year. No other organ involvement has been documented. The patient is New York Heart Association functional class I, with normal resting hemodynamic parameters 1 year after transplantation. Amyloid heart disease does not necessarily portend a poor early outcome.
Conner
R
R
Cardiac Transplant Program, Oregon Health Sciences University, Portland 97201.
Hosenpud
J D
JD
Norman
D J
DJ
Pantely
G A
GA
Cobanoglu
A
A
Starr
A
A
D000686:Amyloidosis / Q000473:pathology / Q000601:surgery*; D006331:Heart Diseases / Q000473:pathology / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors