Chang T-I, Chi N-H, Chou N-K, Tsao C-I, Yu H-Y, Chen Y-S, Wang S-S
Department of Cardiovascular Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Transplant Proc. 2012 May;44(4):903-6. doi: 10.1016/j.transproceed.2012.01.087.
Heart transplantation is the ultimate treatment for end-stage heart failure. Cardiac sarcoidosis has rarely been reported in heart transplantation worldwide. Their long-term prognosis after heart transplantation is unknown. Herein we have presented clinical and pathological observations among heart transplantation patients with isolated cardiac sarcoidosis.
From 1987 to 2011, we performed 411 heart transplantations including five patients retrospectively reviewed due to the presence of sarcoidosis and giant-cell cardiomyopathy in the recipient heart.
Among the heart transplantations from 2003 to 2011, the four male and one female patients were ages 31 to 40 years. None of them had extra-cardiac sarcoidosis. All five subjects presented with dilated cardiomyopathy with patent coronary arteries. The commonest clinical presentations were atrioventricular block, ventricular arrhythmia, electrocardiographic findings of ST elevations, and poor left ventricular ejection fractions (17%-23%). All patients survived without allograft heart failure to date with the longest survivor at 8 years postoperatively. No recurrence of sarcoidosis has been observed clinically or among the post-heart transplantation endomyocardial biopsies.
Heart transplantation is a useful treatment for isolated cardiac sarcoidosis patients suffering end-stage heart failure. Often the diagnosis is difficult to establish before heart transplantation despite endomyocardial biopsy. No recurrence of sarcoidosis was observed among the allografted hearts.
心脏移植是终末期心力衰竭的终极治疗方法。心脏结节病在全球心脏移植中的报道很少。心脏移植后其长期预后尚不清楚。在此，我们报告了孤立性心脏结节病心脏移植患者的临床和病理观察结果。
从1987年到2011年，我们进行了411例心脏移植，其中5例患者因受者心脏存在结节病和巨细胞性心肌病而进行回顾性研究。
在2003年至2011年的心脏移植中，4例男性和1例女性患者年龄在31至40岁之间。他们均无心脏外结节病。所有5例患者均表现为扩张型心肌病且冠状动脉通畅。最常见的临床表现是房室传导阻滞、室性心律失常、ST段抬高的心电图表现以及左心室射血分数较低（17%-23%）。所有患者至今均存活且未发生移植心脏衰竭，最长存活者术后达8年。临床及心脏移植后心内膜活检均未观察到结节病复发。
心脏移植对于患有终末期心力衰竭的孤立性心脏结节病患者是一种有效的治疗方法。尽管进行了心内膜活检，但在心脏移植前往往难以确诊。移植心脏中未观察到结节病复发。
