Cardiac amyloidosis: what are the indications for transplant?

Abstract

Purpose of review: We review the clinical and pathological features of the various types of amyloid that involve the heart, the diagnostic utility of endomyocardial biopsy, and the experience of patient survival and disease recurrence following cardiac transplant for amyloidosis.

Recent findings: Patient outcome is dependent on arresting the cause of amyloid as well as controlling the accumulated damage, which may involve multiple organs. As such, the stratification of patient suitability for cardiac transplant must be considered in conjunction with concurrent treatments, which may include autologous stem cell, liver or kidney transplant, and chemotherapy.

Summary: As the efficacy of these therapies changes, the indications for cardiac transplantation need to be re-evaluated.