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. 2021 Aug;23(4):e13549.
doi: 10.1111/tid.13549. Epub 2021 Jun 1.

Survival after heart transplantation for Chagas cardiomyopathy using a conventional protocol: A 10-year experience in a single center

Luis E Echeverría  1   2 , Antonio Figueredo  2   3 , María J Rodriguez  1 , Leonardo Salazar  2   4 , Camilo Pizarro  2   5 , Carlos A Morillo  6 , Lyda Z Rojas  7 , Sergio A Gómez-Ochoa  8 , Victor R Castillo  3
Affiliations

Survival after heart transplantation for Chagas cardiomyopathy using a conventional protocol: A 10-year experience in a single center

Luis E Echeverría et al. Transpl Infect Dis. 2021 Aug.

Abstract

Background: Heart transplant (HT) remains the most frequently indicated therapy for patients with end-stage heart failure that improves prognosis in Chagas cardiomyopathy (CCM). However, the lack of benznidazole therapy and availability of RT-PCR follow-up in many centers is a major limitation to perform this life-saving intervention, as there are concerns related with the risk of reactivation. We aimed to describe the outcomes of a cohort of patients with CCM who underwent HT using a conventional protocol with mycophenolate mofetil, without benznidazole prophylaxis or RT-PCR follow-up.

Methods: Retrospective cohort study. Between 2008 and 2018, 43 patients with CCM underwent HT. A descriptive analysis to characterize outcomes as rejection, infectious and neoplastic complications and a survival analysis was carried out.

Results: Median of follow-up was 4.3 (IR 4.28) years. Survival at 1 month, 1 year, and 5 years was 95%, 85%, and 75%, respectively, infections being the main cause of death (60%). Reactivations occurred in only three patients (7.34%) and were not related to mortality.

Conclusion: This cohort showed a favorable survival and a low reactivation rate without an impact on mortality. Our results suggest that performing HT in patients with CCM following conventional guidelines and recommendations for other etiologies is a safe approach.

Keywords: Chagas disease; heart failure; heart transplantation.

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References

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