title: Heart transplantation and cardiac amyloidosis: approach to screening and novel management strategies.
abstract: Limited data exist regarding screening methods and outcomes for orthotopic heart transplantation (OHT) in cardiac amyloidosis. As a result, uncertainty exists over the best approach to OHT for cardiac amyloidosis and for the timing of critical post-transplant therapies. This article reviews 6 patients who underwent OHT for cardiac amyloidosis at the Stanford University Amyloid Center from 2008 to present. All patients with light-chain amyloidosis received chemotherapy in the interval between OHT and autologous hematopoietic stem cell transplant. Five patients remain alive up to 25 months after OHT, without evidence of recurrent cardiac amyloid deposition. A novel strategy of OHT, followed by light-chain suppressive chemotherapy before autologous hematopoietic stem cell transplant, is feasible for patients with light-chain amyloidosis.
authors: Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors: Brandon C
authors: BC
authors: Varr
authors: Michaela
authors: M
authors: Liedtke
authors: Sally
authors: S
authors: Arai
authors: Richard A
authors: RA
authors: Lafayette
authors: Stanley L
authors: SL
authors: Schrier
authors: Ronald M
authors: RM
authors: Witteles
mesh_terms: D000368:Aged; D000682:Amyloid / Q000378:metabolism; D000686:Amyloidosis / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D019468:Disease Management; D004358:Drug Therapy; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000628:therapy*; D016027:Heart Transplantation; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000682:Amyloid