Outcome of patients with cardiac sarcoidosis undergoing cardiac transplantation--single-center retrospective analysis.
BACKGROUND
Controversy exists whether heart transplantation (HTx) is an appropriate treatment option for patients with cardiac sarcoidosis due to its potential recurrence and multi-organ involvement. Recent data from the United Network for Organ Sharing dataset suggest that the clinical outcome of cardiac sarcoidosis patients is equivalent or even better than that of the general HTx population.


METHODS
We retrospectively reviewed the clinical course of 14 patients with cardiac sarcoidosis among a total of 825 patients who underwent HTx at Columbia University Medical Center between 1997 and 2010. Post-transplant survival of patients with sarcoidosis was compared with that of non-sarcoidosis patients.


RESULTS
More than half of cardiac sarcoidosis patients were initially diagnosed after HTx by tissue analysis of the explanted heart. While only 2/14 cases showed recurrence of cardiac sarcoidosis, the clinical outcome of sarcoid patients showed a trend toward higher mortality than that of non-sarcoidosis patients following HTx (1- and 5-year survival, 78.5 versus 87.2%, 52.4 versus 76.2%, respectively, p=0.09).


CONCLUSIONS
Although this is a single-center, retrospective analysis of a small number of cardiac sarcoidosis patients who underwent HTx, a concerning trend toward a higher mortality of patients with cardiac sarcoidosis was noted. A careful candidate selection in patients with known cardiac sarcoidosis should be discussed.
Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY, USA.
Hirokazu
H
Akashi
Tomoko S
TS
Kato
Hiroo
H
Takayama
Yoshifumi
Y
Naka
Maryjane
M
Farr
Donna
D
Mancini
P Christian
PC
Schulze
D000328:Adult; D009202:Cardiomyopathies / Q000401:mortality / Q000628:therapy*; D005260:Female; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome