Mediastinal radiation and adverse outcomes after heart transplantation

Nir Uriel, Alan Vainrib, Ulrich P. Jorde, Vlad Cotarlan, Maryjane Farr, Faisal H. Cheema, Yoshifuma Naka, Donna Mancini, Paolo C. Colombo

Research output: Contribution to journalArticle

21 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)378-381
Number of pages4
JournalJournal of Heart and Lung Transplantation
Volume29
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

Fingerprint

Heart Transplantation
Radiation
Radiotherapy
Cardiovascular Diseases
Constrictive Pericarditis
Transplants
Safety
Dilated Cardiomyopathy
Cardiomyopathies
Lymphoma
Neoplasms
Cohort Studies
Survival Rate
Carcinoma

Keywords

  • heart transplantation
  • malignancies
  • morbidity
  • mortality
  • radiation

ASJC Scopus subject areas

  • Transplantation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Mediastinal radiation and adverse outcomes after heart transplantation. / Uriel, Nir; Vainrib, Alan; Jorde, Ulrich P.; Cotarlan, Vlad; Farr, Maryjane; Cheema, Faisal H.; Naka, Yoshifuma; Mancini, Donna; Colombo, Paolo C.

In: Journal of Heart and Lung Transplantation, Vol. 29, No. 3, 03.2010, p. 378-381.

Research output: Contribution to journalArticle

Uriel, N, Vainrib, A, Jorde, UP, Cotarlan, V, Farr, M, Cheema, FH, Naka, Y, Mancini, D & Colombo, PC 2010, 'Mediastinal radiation and adverse outcomes after heart transplantation', Journal of Heart and Lung Transplantation, vol. 29, no. 3, pp. 378-381. https://doi.org/10.1016/j.healun.2009.08.011
Uriel, Nir ; Vainrib, Alan ; Jorde, Ulrich P. ; Cotarlan, Vlad ; Farr, Maryjane ; Cheema, Faisal H. ; Naka, Yoshifuma ; Mancini, Donna ; Colombo, Paolo C. / Mediastinal radiation and adverse outcomes after heart transplantation. In: Journal of Heart and Lung Transplantation. 2010 ; Vol. 29, No. 3. pp. 378-381.
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