Heart Transplantation for Cardiac Amyloidosis - Worthwhile?

Purpose Cardiac amyloidosis (CA) (both AL and TTR) results in restrictive cardiomyopathy (RCM) and is associated with a high mortality with a median survival of Methods Between 2010 and 2017 803 patients underwent HTx. We identified 41 patients who underwent HTx for CA (11 AL; 30 TTR). We compared these to 18 patients who underwent HTx for other types of RCM. We assessed 3-year actuarial survival, freedom from angiographic cardiac allograft vasculopathy (CAV) (>= 30% stenosis), non-fatal major adverse cardiac events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke) and rejection. Results Patients undergoing HTx for ATTR were significantly older than AL or RCM patients (69.7 vs 57.7 vs 47.8 yrs (p Conclusion HTx for CA in appropriately selected patients is associated with comparable outcomes at 3 years to patients undergoing HTx for other forms of RCM.