HEART TRANSPLANTATION FOR CARDIOMYOPATHY CAUSED BY

DIEZ M; BERTOLOTTI A; FAVALORO L; PERADEJORDI LASTRA M; VIGLIANO C; SCHIJMAN A; BURGOS J; FAVALORO RR

Barcelona

Congreso; World Congress of Cardiology 2006; 2006

European Society of Cardiology

Chagasic cardiomyopathy (ChC) is an important cause of end-stage heartfailurein South America. Heart transplantation (HTx) is a useful therapy; however,reactivation (Ra) of Chagas disease is one of the main complicationsobserved.Objective: to evaluate the prevalence of Ra in HTx recipients (R) due to ChC andcompare the outcome of this patients to others etiologies.Material and methods: Ten out of 222 HTx R had ChC -Group 1-The etiologiesinthe 212 remainder HTxR -Group 2- were idiopathic cardiomyopathy(n:57;27%),ischemic (n:90;42.5%), valvular (n:16;7.5%), congenital (n:8;3.8%) andothers(n:41;19.3%). At the time of endomyocardial biopsies, parasitemia wasdeterminedby the Strout method, and DNA amplification of the parasite by PCR toassess Ra. Prophylactic benznidazole was not given.Results: the in-hospital mortality rate was 10% in G1 vs 16% in G2 (p:0.5). FiveCh pts exhibited Ra (50%); 4 had skin lesions and 1 had Chagasmyocarditis.The mean Ra time was 71.6 days (d)(range 38-92). All the Ra weresuccessfullytreated with benznidazole; the Strout and PCR results became negative.Survival at 1 and 3 years was 80% and 80% for G1 and 79.5% and 75% in G2(p:0.7). Causes of death were sepsis (n1;10%) and refractory acuterejection(AR)(n:1;10%) in G1, and the leading causes in G2 were sepsis (n15; 7%),acute graftfailure (n:8;3.7%), malignancy (n:6; 3%), and AR (n:5; 2.3%)Conclusions: Ra was observed in 50% of HTx chagasic R, treatmentwithbeznidazol was successful in all the cases and any pts died because ofRa. Thesurvival results are similar to others etiologies. This confirms thatHTx is a valuabletreatment option in ChC.