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- W2024067570 abstract "Chagasitic cardiomyopathy remains a rare indication for heart transplantation in the United States and carries a risk for re-activation in presence of immunosuppressive therapy. Due to its low prevalance at any transplant center, management and outcomes of this population in the post-transplant period is not well defined. We sought to investigate post-transplant management and outcomes of this cohort using the UNOS registry. A retrospective review of the UNOS registry was performed to identify patients with the primary diagnosis of Chagas Disease receiving a heart transplant between 1987 and 2014. 17 patients were identified and the effect of induction therapy on their outcomes was assessed. 17 patients between 1989 and 2014 were transplanted with primary diagnosis listed as Chagas disease. 16 of 17 were listed of Hispanic/Latino ethnicity (1 not reported). Mean patient age was 51.2±7.2 years, mean BMI 23.8±3.3, with 7 of 17 patients female (41.2%). Patients were transplanted in UNOS regions 1 (n=4), 2 (n=1), 5 (n=7), 6 (n=2) and 9 (n=3). Mean survival was 87.4% at 2 years, 57.9% at 10 years, comparable to overall survival in heart transplant patients (Figure A). 16 of 17 patients underwent standard triple maintenance therapy, with use of calcineurin inhibitor (CNI), anti-metabolite, and steroids. 5 of 17 received induction therapy at the time of transplant using OKT3 (n=1), anti-thymocyte globulin (n=2) and daclizumab (n=2). Induction therapy was associated with similar infection rates (Figure B), and a trend towards early protection from rejection (Figure C). Although data on Chagas reactivation post-transplant is not available through the UNOS database, we demonstrate that patients with Chagasitic cardiomyopathy have comparable post-transplant infection, rejection, and mortality risk profile compared to patients transplanted for other indications, supporting use of cardiac transplantation in these patients." @default.
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- W2024067570 date "2015-04-01" @default.
- W2024067570 modified "2023-09-27" @default.
- W2024067570 title "Management of Chagas Cardiomyopathy Patients Following Cardiac Transplantation: Implications From the Unos Database" @default.
- W2024067570 doi "https://doi.org/10.1016/j.healun.2015.01.510" @default.
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