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Survival after heart transplantation for Chagas cardiomyopathy using a conventional protocol: A 10‐year experience in a single center
Author(s) -
Echeverría Luis E.,
Figueredo Antonio,
Rodriguez María J.,
Salazar Leonardo,
Pizarro Camilo,
Morillo Carlos A.,
Rojas Lyda Z.,
GómezOchoa Sergio A.,
Castillo Victor R.
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13549
Subject(s) - medicine , benznidazole , cohort , heart transplantation , cardiomyopathy , retrospective cohort study , single center , etiology , cohort study , transplantation , heart failure , surgery , parasite hosting , trypanosoma cruzi , world wide web , computer science
Background Heart transplant (HT) remains the most frequently indicated therapy for patients with end‐stage heart failure that improves prognosis in Chagas cardiomyopathy (CCM). However, the lack of benznidazole therapy and availability of RT‐PCR follow‐up in many centers is a major limitation to perform this life‐saving intervention, as there are concerns related with the risk of reactivation. We aimed to describe the outcomes of a cohort of patients with CCM who underwent HT using a conventional protocol with mycophenolate mofetil, without benznidazole prophylaxis or RT‐PCR follow‐up. Methods Retrospective cohort study. Between 2008 and 2018, 43 patients with CCM underwent HT. A descriptive analysis to characterize outcomes as rejection, infectious and neoplastic complications and a survival analysis was carried out. Results Median of follow‐up was 4.3 (IR 4.28) years. Survival at 1 month, 1 year, and 5 years was 95%, 85%, and 75%, respectively, infections being the main cause of death (60%). Reactivations occurred in only three patients (7.34%) and were not related to mortality. Conclusion This cohort showed a favorable survival and a low reactivation rate without an impact on mortality. Our results suggest that performing HT in patients with CCM following conventional guidelines and recommendations for other etiologies is a safe approach.