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Heart transplantation in end-stage heart failure secondary to cardiac sarcoidosis: an updated systematic review

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Abstract

The prevalence of cardiac sarcoidosis is increasing with improved cardiac imaging and may lead to severe heart failure, cardiomyopathy, and arrhythmias that warrant heart transplant consideration. This study aimed to evaluate the outcomes of heart transplantation in sarcoidosis. We systematically searched PubMed/MEDLINE, EMBASE and Cochrane Library following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. We identified 15 articles that examined patients with cardiac sarcoidosis. The study aimed to evaluate the outcomes of heart transplantation in cardiac sarcoidosis. We systematically searched EMBASE, PubMed/MEDLINE, and Cochrane Library following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We identified 15 studies that examined 1075 patients with cardiac sarcoidosis who underwent heart transplantation. A total of five studies reported individual patient data. Forty-two patients have been pooled for further analysis. There were 22 male patients, 14 female patients, and 7 patients whose gender was not reported. Among these patients, 10 patients had concomitant pulmonary sarcoidosis at the time of diagnosis. The mean survival was reported for all 42 patients. The mean survival in months was 71.4 months, with a range of 2 days to 288 months. Three patients died of graft failure, 2 patients from septic shock, 2 patients from pneumonia, 1 patient from cervical cancer, and 1 patient from sudden cardiac death. One patient developed a malignant arrythmia in the setting of CMV myocarditis post-heart transplant. Sarcoidosis recurrence after heart transplant was reported in 3 of 30 patients..Patients with cardiac sarcoidosis have shown to have favorable outcomes after heart transplant. Despite these outcomes, some centers still hesitate to pursue heart transplant for CS patients. Carefully selected patients with advanced-stage heart failure due to cardiac sarcoidosis have encouraging outcomes after transplantation. Further studies will be needed to evaluate the outcomes of heart transplantation in sarcoidosis.

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Authors and Affiliations

  1. Department of Cardiology, Tulane Hospital, New Orleans, LA, USA

    Chandan Buttar

  2. Department of Cardiology, Ochsner Medical Center, New Orleans, LA, USA

    Sofia Lakhdar & Thota Pavankumar

  3. Department of Medicine, Icahn School of Medicine at Mount Sinai/NYC H+H/Queens, Queens, NY, USA

    Laura Guzman-Perez

  4. Department of Heart Failure and Transplant, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Kiran Mahmood

  5. Division of Cardiology, Icahn School of Medicine at Mount Sinai, NYC H+H/Queens, Queens, NY, USA

    Giovina Collura

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  1. Chandan Buttar
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  3. Thota Pavankumar
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  5. Kiran Mahmood
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Contributions

SL and CB conceived the study. SL and CB designed the study and performed the literature search. All authors contributed to the interpretation, writing, and editing of the manuscript.

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Correspondence to Sofia Lakhdar.

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Buttar, C., Lakhdar, S., Pavankumar, T. et al. Heart transplantation in end-stage heart failure secondary to cardiac sarcoidosis: an updated systematic review. Heart Fail Rev 28, 961–966 (2023). https://doi.org/10.1007/s10741-022-10284-0

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  • DOI: https://doi.org/10.1007/s10741-022-10284-0

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