Outcomes in patients with cardiac amyloidosis undergoing heart transplantation: the eurotransplant experience
Section snippets
Methods
The study conforms with the principles outlined in the Declaration of Helsinki, as well as the ISHLT statement on transplant ethics22,23 and was conducted in a retrospective approach. Patient data was provided by Eurotransplant as collected in the Eurotransplant registry. The Eurotransplant registry gathers information on all patients listed for HTX in the Eurotransplant region through reports from each transplant centre.
Survival following HTX
Median overall survival following HTX for all patients (n = 115) was 2228 days (6.3 years), Figure 1) and also 6.3 years in the subgroup of 85 patients with more detailed information. Fifty-four patients (39%) died within the study period. Median survival was numerically longer in ATTR amyloidosis patients (4447 days, 12.2 years) than in AL amyloidosis patients (1631 days, 4.5 years). However, there was no statistically significant difference in survival between both amyloidosis subtypes (p
Discussion
We here present one of the largest cohorts of patients with heart transplantations due to cardiac amyloidosis.14,15,18,19 Moreover, our study is the first multinational one demonstrating that HTX for cardiac amyloidosis is a feasible treatment option. Besides, the relatively high number of patients allows for the first time the identification of potential factors in this patient group that can be correlated with patient survival after HTX. Thus, we do not only present HTX as a feasible
Conclusion
When amyloid cardiomyopathy turns into advanced heart failure, treatment options are very limited. Heart transplantation is safe, feasible and can approach survival seen in non-amyloid patients. This needs to be taken into special consideration in view of the great advancements in the treatment of advanced heart failure in recent years – knowing that these new therapeutic options showed little effect on amyloidosis patients. Yet, careful patient selection and contemporary therapy strategies for
Authors' Contribution
Martin J. Kraus: Conceptualization, Methodology, Formal analysis, Investigation, Data Curation, Writing, Visualization, Supervision. Jacqueline M. Smits: Supervision, Investigation, Resources, Methodology, Validation. Anna L. Meyer: Investigation, Review. Agita Strelniece: Resources, Investigation. Arne van Kins: Resources, Investigation. Udo Boeken: Investigation, Review. Alexander Reinecke: Investigation, Review. Zdenek Provaznik: Investigation, Review. Oliver Van Caenegem: Investigation.
Disclosure statement
The authors have no conflicts of interest to disclose. This manuscript received no funding.
Acknowledgments
We would like to thank Myriam Wittek and André Hochgesand for assistance with data acquisition and analysis.
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