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

Todd C. Crawford, David R. Okada, J. Trent Magruder, Charles Fraser, Nishant Patel, Brian A. Houston, Glenn Whitman, Kaushik Mandal, Kenton J Zehr, Robert Higgins, Edward Chen, Harikrishna Tandri, Edward K Kasper, Ryan J. Tedford, Stuart D. Russell, Nisha Gilotra

Research output: Contribution to journalArticle

Abstract

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 BTT 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 BTT cohorts. Both HT and BTT MCS should be considered in patients with CS.

Original languageEnglish (US)
JournalJournal of Cardiac Failure
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Heart Transplantation
Sarcoidosis
Transplants
Survival
Mortality
Cardiomyopathies
Registries

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A Contemporary Analysis of Heart Transplantation and Bridge-to-Transplant Mechanical Circulatory Support Outcomes in Cardiac Sarcoidosis. / Crawford, Todd C.; Okada, David R.; Magruder, J. Trent; Fraser, Charles; Patel, Nishant; Houston, Brian A.; Whitman, Glenn; Mandal, Kaushik; Zehr, Kenton J; Higgins, Robert; Chen, Edward; Tandri, Harikrishna; Kasper, Edward K; Tedford, Ryan J.; Russell, Stuart D.; Gilotra, Nisha.

In: Journal of Cardiac Failure, 01.01.2018.

Research output: Contribution to journalArticle

Crawford, Todd C. ; Okada, David R. ; Magruder, J. Trent ; Fraser, Charles ; Patel, Nishant ; Houston, Brian A. ; Whitman, Glenn ; Mandal, Kaushik ; Zehr, Kenton J ; Higgins, Robert ; Chen, Edward ; Tandri, Harikrishna ; Kasper, Edward K ; Tedford, Ryan J. ; Russell, Stuart D. ; Gilotra, Nisha. / A Contemporary Analysis of Heart Transplantation and Bridge-to-Transplant Mechanical Circulatory Support Outcomes in Cardiac Sarcoidosis. In: Journal of Cardiac Failure. 2018.
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abstract = "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 BTT 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 BTT cohorts. Both HT and BTT MCS should be considered in patients with CS.",
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AU - Crawford, Todd C.

AU - Okada, David R.

AU - Magruder, J. Trent

AU - Fraser, Charles

AU - Patel, Nishant

AU - Houston, Brian A.

AU - Whitman, Glenn

AU - Mandal, Kaushik

AU - Zehr, Kenton J

AU - Higgins, Robert

AU - Chen, Edward

AU - Tandri, Harikrishna

AU - Kasper, Edward K

AU - Tedford, Ryan J.

AU - Russell, Stuart D.

AU - Gilotra, Nisha

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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 BTT 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 BTT cohorts. Both HT and BTT MCS should be considered in patients with CS.

AB - 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 BTT 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 BTT cohorts. Both HT and BTT MCS should be considered in patients with CS.

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KW - propensity score matching

KW - Sarcoidosis

KW - survival analysis

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