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 Scopus citations

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 1 2010
Externally publishedYes

Keywords

  • heart transplantation
  • malignancies
  • morbidity
  • mortality
  • radiation

ASJC Scopus subject areas

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

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  • Cite this

    Uriel, N., Vainrib, A., Jorde, U. P., Cotarlan, V., Farr, M., Cheema, F. H., Naka, Y., Mancini, D., & Colombo, P. C. (2010). Mediastinal radiation and adverse outcomes after heart transplantation. Journal of Heart and Lung Transplantation, 29(3), 378-381. https://doi.org/10.1016/j.healun.2009.08.011