263: Cardiac transplantation for giant cell myocarditis: A single center experience

Shao, E.; Chen, T.E.; Wu, Guangjie; Patel, Jignesh; Kobashigawa, J.A.

doi:10.1016/j.healun.2006.11.282

Cited by 2 publications

(8 citation statements)

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“…The prognosis of patients with a heart transplant for giant cell myocarditis is good and similar to that of patients that had an allograft for other indications. 1,[15][16][17] In conclusion, in presence of refractory subacute heart failure, we believe that it is reasonable to perform endomyocardial biopsy in the absence of left ventricular dilatation, especially if the clinical course is marked by a subsequent rapid deterioration of the LVEF, occurrence of malignant ventricular arrhythmias, or atrioventricular blocks. …”

Section: Discussionmentioning

confidence: 94%

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Berthelot-Richer

O’Connor²,

Bernier³

et al. 2014

Exp Clin Transplant

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Objectives: Giant cell myocarditis is a rare and often fatal disorder. According to the American Heart Association, the American College of Cardiology Foundation, and the European Society of Cardiology scientific statements, an endomyocardial biopsy should be done to exclude giant cell myocarditis in unexplained new-onset heart failure of 2 weeks to 3 months duration associated with dilated left ventricle and new ventricular arrhythmias, or Mobitz type II second-degree, or third-degree atrioventricular heart block. Case Presentations: Two hundred thirty-five heart transplants were performed since May 1993 at the Institut universitaire de cardiologie et de pneumologie de Quebec, Canada. Giant cell myocarditis was found in the explanted hearts of 5 patients. The preoperative diagnosis of giant cell myocarditis was done by endomyocardial biopsy or at the installation of a left ventricular-assisted device. Patients had symptoms of progressive heart failure of subacute onset. Patients consulted at a mean 32 days after the onset of symptoms. Two patients neither had ventricular arrhythmia nor heart block. Two patients had ventricular arrhythmias and heart block; the other patient had symptomatic heart block. All patients had at least 2 echocardiographies. Two patients had an increase in left ventricular size, enough to reach the criteria of left ventricular dilatation according to the American Society of Echocardiography. During this time, left ventricular ejection fraction showed a rapid decline (mean 37% to 16%). Conclusions: Ventricular arrhythmia, heart block, and left ventricular dilatation initially can be absent in many patients having giant cell myocarditis with symptoms of progressive heart failure. Endomyocardial biopsy should be quickly considered in patients with a rapid and dramatic decline of left ventricular ejection fraction, even in the absence of classic clinical and echocardiographic features of giant cell myocarditis to rapidly obtain the diagnosis of this rare but lethal disease.

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Section: Discussionmentioning

confidence: 94%

Untitled

Berthelot-Richer

O’Connor²,

Bernier³

et al. 2014

Exp Clin Transplant

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“…Ten studies reported separate outcomes for CS patients, two reported separate outcomes of patients with GCM, and two reported outcomes for both diseases. The overall 1-, 5-, or 10-year survival rates for patients with either CS [ 6 – 8 , 20 , 21 , 23 , 25 , 27 , 30 , 31 ] or GCM [ 14 , 21 , 24 , 31 ] after HTx were described in 12 publications. One- or 5-year acute cellular rejection rates after HTx for either CS [ 8 , 21 , 27 , 30 , 31 ] or GCM [ 14 , 21 , 24 , 31 ], as well as disease recurrence at any time post-HTx in patients with CS [ 6 , 8 , 20 , 21 , 28 , 30 , 31 ] or GCM [ 21 , 31 ], were reported in seven studies each.…”

Section: Resultsmentioning

confidence: 99%

“…The overall 1-, 5-, or 10-year survival rates for patients with either CS [ 6 – 8 , 20 , 21 , 23 , 25 , 27 , 30 , 31 ] or GCM [ 14 , 21 , 24 , 31 ] after HTx were described in 12 publications. One- or 5-year acute cellular rejection rates after HTx for either CS [ 8 , 21 , 27 , 30 , 31 ] or GCM [ 14 , 21 , 24 , 31 ], as well as disease recurrence at any time post-HTx in patients with CS [ 6 , 8 , 20 , 21 , 28 , 30 , 31 ] or GCM [ 21 , 31 ], were reported in seven studies each. Histopathological diagnosis of acute cellular rejection in endomyocardial biopsies was reported according to the ISHLT grading scale [ 32 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were not assessed for the risk of bias, since they were only available in abstract form and our contact with the authors was unsuccessful. [23][24][25]…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…After removal of duplicates, 6582 articles remained: 6529 were discarded after review of titles and/or abstracts and 39 of the remaining 53 were rejected after full-text review. Among the 14 remaining studies, there were published 9 articles [6-8, 14, 20, 27-30] and 5 peer-reviewed abstracts [21,[23][24][25]31]. Two authors of peer-reviewed conference abstracts provided additional data, thus allowing for a more extensive assessment of their work [21,31].…”

Section: Literature Searchmentioning

confidence: 99%

See 2 more Smart Citations

Short- and long-term outcomes after heart transplantation in cardiac sarcoidosis and giant-cell myocarditis: a systematic review and meta-analysis

et al. 2021

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Heart transplantation (HTx) is a valid therapeutic option for end-stage heart failure secondary to cardiac sarcoidosis (CS) or giant-cell myocarditis (GCM). However, post-HTx outcomes in patients with inflammatory cardiomyopathy (ICM) have been poorly investigated. We searched PubMed, Scopus, Science Citation Index, EMBASE, and Google Scholar, screened the gray literature, and contacted experts in the field. We included studies comparing post-HTx survival, acute cellular rejection, and disease recurrence in patients with and without ICM. Data were synthesized by a random‐effects meta‐analysis. We screened 11,933 articles, of which 14 were considered eligible. In a pooled analysis, post-HTx survival was higher in CS than non-CS patients after 1 year (risk ratio [RR] 0.88, 95% confidence interval [CI] 0.60–1.17; I2 = 0%) and 5 years (RR 0.72, 95% CI 0.52–0.91; I2 = 0%), but statistically significant only after 5 years. During the first-year post-HTx, the risk of acute cellular rejection was similar for patients with and without CS, but after 5 years, it was lower in those with CS (RR 0.38, 95% CI 0.03–0.72; I2 = 0%). No difference in post-HTx survival was observed between patients with and without GCM after 1 year (RR 1.16, 95% CI 0.05–2.28; I2 = 0%) or 5 years (RR 0.98, 95% CI 0.42–1.54; I2 = 0%). During post-HTx follow-up, recurrence of CS and GCM occurred in 5% and 8% of patients, respectively. Post-HTx outcomes in patients with CS and GCM are comparable with cardiac recipients with other heart failure etiologies. Patients with ICM should not be disqualified from HTx. Graphic abstract

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263: Cardiac transplantation for giant cell myocarditis: A single center experience

Cited by 2 publications

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Short- and long-term outcomes after heart transplantation in cardiac sarcoidosis and giant-cell myocarditis: a systematic review and meta-analysis

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