With a minimal incidence of amyloid recurrence in the cardiac allograft, cardiac transplantation is well tolerated, increases functional ability, and lengthens survival in patients with ATTR-CM, according to a 30-year retrospective study. ATTR-CM should be included in the list of transplantation indications.
Cardiomyopathy caused by transthyretin amyloidosis cardiomyopathy (ATTR-CM) is progressive and fatal. Patients with severe heart failure have only cardiac transplantation (CT) as a treatment option. Despite a few modest case studies showing similar CT results for patients with ATTR-CM and non-amyloid cardiomyopathies, several centers still view ATTR-CM as a complete contraindication to CT. A presumed risk of amyloid recurrence in the cardiac allograft is one reason for this. This retrospective study was published in the European Heart Journal and discussed the outcomes of patients with ATTR-CM evaluated over the previous 30 years who underwent CT at the UK National Amyloidosis Centre.
All ATTR-CM patients who received CT and were checked between 1990 and 2020 were retrospectively evaluated. A sizable cohort of ATTR-CM patients who were not transplanted was used to compare outcomes and identify pre-transplantation illness and patient characteristics.