Heart transplants provide value for patients with AL, ATTR cardiac amyloidosis
Heart transplants can lead to positive outcomes for patients with cardiac amyloidosis, according to new findings published in JACC: Heart Failure. With the disease becoming more and more common in the United States, researchers have been hard at work determining the best possible treatment options.
“No cardiac medications or implantable devices have been shown to improve mortality for patients with amyloid cardiomyopathy,” wrote first author Christopher D. Barrett, MD, University of Colorado Denver, and colleagues. “Heart transplantation is one option for treating amyloid cardiomyopathy, but its use has been controversial due to early reports of poor post-transplantation outcomes. In a system that lacks sufficient organs to meet demand, offering heart transplantation for cardiac amyloidosis has been hypothesized by some to be a poor allocation of a limited resource.”
Barrett et al. noted that their initial research into treating this deadly disease with heart transplants yielded encouraging results, leading them to conduct a larger study that examined more transplant recipients after more time had passed.
The team explored data from 31 patients from one of two medical centers who were diagnosed with cardiac amyloidosis and underwent a heart transplant from 2004 to 2017. While 13 patients had light chain (AL) amyloidosis, the other 18 had transthyretin (ATTR) amyloidosis.
Overall the researchers found “no significant difference in mortality” between cardiac amyloidosis patients undergoing a heart transplant and other heart transplant patients from the same academic centers. Patients with ATTR amyloidosis tended to be older, male and had worse baseline renal function. The waitlist time was also longer for these individuals.
Barrett and colleagues gave some credit for the positive numbers to their transportation program’s wisely constructed protocols.
“Because cardiac transplantation is a costly, labor-intensive, and organ-limited resource, appropriate patient selection is crucial for determining which patients may benefit most from this therapy,” the authors wrote. “A rigorous selection process takes place before listing patients for organ transplantation at our institution, and it is likely that our favorable post-transplantation outcomes are in large part due to careful patient screening.”
The team did note that the size of their study cohort was “relatively small” compared to the number of patients who receive heart transplants for other reasons. However, they concluded, the findings do suggest that “carefully selected patients with AL and ATTR cardiac amyloidosis” can achieve positive post-transplantation outcomes.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.