A Contemporary Analysis of Heart Transplantation and Bridge-to-Transplant Mechanical Circulatory Support Outcomes in Cardiac Sarcoidosis

作者：Crawford Todd C; Okada David R; Magruder J Trent; Fraser Charles; Patel Nishant; Houston Brian A; Whitman Glenn J; Mandal Kaushik; Zehr Kenton J; Higgins Robert S; Chen Edward S; Tandri Hari; Kasper Edward K; Tedford Ryan J; Russell Stuart D; Gilotra Nisha A^*

来源：Journal of Cardiac Failure, 2018, 24(6): 384-391.

DOI：10.1016/j.cardfail.2018.02.009

• Sarcoidosis
• heart transplantation
• survival analysis
• propensity score matching

Background: Patients with end-stage cardiomyopathy due to cardiac sarcoidosis (CS) may be referred for mechanical circulatory support (MCS) and heart transplantation (HT). We describe outcomes of patients with CS undergoing HT, focusing on the use of MCS as a bridge to transplant (BTT).
Methods: Using the United Network for Organ Sharing Scientific Registry of Transplant Recipients, we identified all adult waitlisted patients and isolated HT recipients from 2006 to 2015. These were divided into those with and without CS and further divided into those who did or did not receive MCS as BTT. Outcomes included 1- and 5-year post-transplantation freedom from mortality and 5-year freedom from primary graft failure.
Results: Over the study period, 31,528 patients were listed for HT, 148 (0.4%) of whom had CS. Among the CS patients, 34 (23%) received MCS as BTT. 18,348 patients (58%) eventually underwent HT, including 67 (0.4%) with CS, 20 (30%) of whom had received BTT MCS. Compared with non-CS diagnoses, CS patients had similar 1-year (91% vs 90%; log rank P = .88) and 5-year (83% vs 77%; log rank P = .46) freedom from mortality. Survival was also similar between CS BTT and non-CS BIT groups at 1 year (89% vs 89%; log-rank P = .92) and 5 years (72% vs 75%; log-rank P = .77).
Conclusions: Survivals after HT were similar between CS and non-CS patients out to 5 years, and were also similar between CS and non-CS BIT cohorts. Both HT and BIT MCS should be considered in patients with CS.

• 出版日期2018-6