Outcomes after heart transplantation for al compared to ATTR cardiac amyloidosis

Light‐chain (AL) cardiac amyloidosis (CA) has a worse prognosis than transthyretin (ATTR) CA. In this single‐center study, we compared post‐heart transplant (OHT, orthotopic heart transplantation) survival for AL and ATTR amyloidosis, hypothesizing that these differences would persist post‐OHT. Thir...

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Veröffentlicht in:Clinical transplantation 2020-10, Vol.34 (10), p.e14028-e14028
Hauptverfasser: Griffin, Jan M., Chiu, Leonard, Axsom, Kelly M., Bijou, Rachel, Clerkin, Kevin J., Colombo, Paolo, Cuomo, Margaret O., De Los Santos, Jeffeny, Fried, Justin A., Goldsmith, Jeff, Habal, Marlena, Haythe, Jennifer, Helmke, Stephen, Horn, Evelyn M., Latif, Farhana, Hi Lee, Sun, Lin, Edward F., Naka, Yoshifumi, Raikhelkar, Jayant, Restaino, Susan, Sayer, Gabriel T., Takayama, Hiroo, Takeda, Koji, Teruya, Sergio, Topkara, Veli, Tsai, Emily J., Uriel, Nir, Yuzefpolskaya, Melana, Farr, Maryjane A., Maurer, Mathew S.
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container_end_page e14028
container_issue 10
container_start_page e14028
container_title Clinical transplantation
container_volume 34
creator Griffin, Jan M.
Chiu, Leonard
Axsom, Kelly M.
Bijou, Rachel
Clerkin, Kevin J.
Colombo, Paolo
Cuomo, Margaret O.
De Los Santos, Jeffeny
Fried, Justin A.
Goldsmith, Jeff
Habal, Marlena
Haythe, Jennifer
Helmke, Stephen
Horn, Evelyn M.
Latif, Farhana
Hi Lee, Sun
Lin, Edward F.
Naka, Yoshifumi
Raikhelkar, Jayant
Restaino, Susan
Sayer, Gabriel T.
Takayama, Hiroo
Takeda, Koji
Teruya, Sergio
Topkara, Veli
Tsai, Emily J.
Uriel, Nir
Yuzefpolskaya, Melana
Farr, Maryjane A.
Maurer, Mathew S.
description Light‐chain (AL) cardiac amyloidosis (CA) has a worse prognosis than transthyretin (ATTR) CA. In this single‐center study, we compared post‐heart transplant (OHT, orthotopic heart transplantation) survival for AL and ATTR amyloidosis, hypothesizing that these differences would persist post‐OHT. Thirty‐nine patients with CA (AL, n = 18; ATTR, n = 21) and 1023 non‐amyloidosis subjects undergoing OHT were included. Cox proportional hazards modeling was used to evaluate the impact of amyloid subtype and era (early era: from 2001 to 2007; late era: from 2008 to 2018) on survival post‐OHT. Survival for non‐amyloid patients was greater than ATTR ( P  = .034) and AL ( P  
doi_str_mv 10.1111/ctr.14028
format Article
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In this single‐center study, we compared post‐heart transplant (OHT, orthotopic heart transplantation) survival for AL and ATTR amyloidosis, hypothesizing that these differences would persist post‐OHT. Thirty‐nine patients with CA (AL, n = 18; ATTR, n = 21) and 1023 non‐amyloidosis subjects undergoing OHT were included. Cox proportional hazards modeling was used to evaluate the impact of amyloid subtype and era (early era: from 2001 to 2007; late era: from 2008 to 2018) on survival post‐OHT. Survival for non‐amyloid patients was greater than ATTR ( P  = .034) and AL ( P  &lt; .001) patients in the early era. One, 3‐, and 5‐year survival rates were higher for ATTR patients than AL patients in the early era (100% vs 75%, 67% vs 50%, and 67% vs 33%, respectively, for ATTR and AL patients). Survival in the non‐amyloid cohort was 87% at 1 year, 81% at 3 years, and 76% at 5 years post‐OHT. In the late era, AL and ATTR patients had unadjusted 1‐year, 3‐year, and 5‐year survival rates of 100%, which was comparable to non‐amyloid patients (90% vs 84% vs 81%). 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In the late era, AL and ATTR patients had unadjusted 1‐year, 3‐year, and 5‐year survival rates of 100%, which was comparable to non‐amyloid patients (90% vs 84% vs 81%). Overall, these findings demonstrate that in the current era, differences in post‐OHT survival for AL compared to ATTR are diminishing; OHT outcomes for selected patients with CA do not differ from non‐amyloidosis patients.</abstract><pmid>32623785</pmid><doi>10.1111/ctr.14028</doi><orcidid>https://orcid.org/0000-0001-8217-9822</orcidid><orcidid>https://orcid.org/0000-0002-8561-7899</orcidid><orcidid>https://orcid.org/0000-0003-1729-7464</orcidid><orcidid>https://orcid.org/0000-0001-8351-9219</orcidid><oa>free_for_read</oa></addata></record>
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title Outcomes after heart transplantation for al compared to ATTR cardiac amyloidosis
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