Abstract 4144168: Five Years Post Heart Transplant Outcomes in Patients with Amyloidosis: A Single Center Experience

Introduction: Many patients with amyloidosis can have advanced cardiac involvement, that drives mortality. Due to lack of definitive therapies that can reverse cardiac infiltration, cardiac replacement is the only hope for these patients. Durable left ventricular assist devices are not a good option; hence heart transplant remains mainstay. We present here long-term outcomes from a single center. Methods: Using EPIC Electronic Health Records’ database Clarity and UNOS center-specific report builder, we abstracted clinical information of patients who underwent a heart transplantation for cardiac amyloidosis at our center from 2004 to 2023. Results: Fifty-one patients underwent heart transplant for cardiac amyloidosis: 32 for Amyloid Light chain (AL) and 19 for Amyloidosis Transthyretin (TTR). Majority were males (Table 1). Of the AL transplants, 6 received concomitant kidney, 2 liver and 2 lung transplantation and of the TTR, 1 received concomitant kidney and 16 concomitant liver transplantation. There were more multi-organs in TTR compared to AL cardiac transplants (17 vs 10, p<0.001). The majority (78%) were transplanted at a higher listing status (Status 1A in older system and Status 2 in the newer system) and in the ICU at the time of transplant. Donor, baseline, and post-transplant characteristics are presented in Table 1. Five-year survival for AL cardiac transplantation was 71% compared to 92% in TTR amyloidosis with no significant difference between both (Figure 1). Majority of the causes of death were noncardiac. Conclusion: Select patients with end stage AL and TTR amyloidosis can successfully have prolongation of life with heart transplantation like any other etiology of end stage heart failure. Their 5 year outcomes are similar to other non-amyloid transplant patients reported in national registries.