Mediastinal radiation and adverse outcomes after heart transplantation. Academic Article uri icon

Overview

abstract

  • Orthotopic heart transplantation (OHT) may represent the only treatment option for patients with end-stage cardiovascular disease due to mediastinal radiation therapy (MRT). The primary aim of this study was to evaluate the safety and efficacy of OHT in this patient population. We conducted a retrospective, single-center cohort study of patients with MRT-associated cardiovascular disease who underwent OHT between January 1987 and September 2008. Nine patients (3 men), aged 46 +/- 11 years at the time of their OHT, were identified. Time from MRT to OHT was 26 +/- 11 years. Lymphoma was the indication for MRT in all patients. Five patients had non-ischemic dilated cardiomyopathy, 2 had ischemic cardiomyopathy and 2 had constrictive pericarditis. Three patients expired in the peri-operative period, whereas another patient died 3 years post-transplant from lung carcinoma. Two additional patients developed a secondary malignancy post-transplant. Five patients are still alive at a mean follow-up of 10 +/- 8 years. Early survival rate is poor in patients who undergo OHT for MRT-associated end-stage cardiovascular disease. In addition, long-term follow-up shows an elevated incidence of malignancies. Our results raise concern about the safety and efficacy of performing OHT in patients with MRT-associated cardiovascular disease.

publication date

  • October 4, 2009

Research

keywords

  • Cardiomyopathies
  • Heart Transplantation
  • Hodgkin Disease
  • Lymphoma, Non-Hodgkin
  • Mediastinum
  • Radiotherapy

Identity

Scopus Document Identifier

  • 77349115964

Digital Object Identifier (DOI)

  • 10.1016/j.healun.2009.08.011

PubMed ID

  • 19804988

Additional Document Info

volume

  • 29

issue

  • 3