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Double organ transplantation in cardiac amyloidosis

Gkouziouta, Aggeliki; Farmakis, Dimitrios; Manginas, Athanassios; Sfyrakis, Petros; Saroglou, Georgios; Adamopoulos, Stamatis; Iliodromitis, Efstathios K.

Journal of Cardiovascular Medicine: February 2016 - Volume 17 - Issue 2 - p 126–129
doi: 10.2459/JCM.0000000000000216
Cardiac amyloidosis

Background Cardiac amyloidosis, particularly primary or AL amyloidosis, is the most common infiltrative cardiomyopathy and is associated with a poor prognosis. The outcome of cardiac transplantation is generally poor, and almost half of patients die while waiting for the procedure to be done.

Patient We report here the remarkable case of a 63-year-old man with heart failure caused by AL amyloidosis. After a long course, which included rapid deterioration of preexisting heart failure, cardiac arrest, cardiogenic shock, biventricular assist device support, heart transplantation, renal failure, kidney transplantation and finally a life-threatening H1N1 virus pneumonia, the patient managed not only to survive but also to return fully to his previous demanding duties and lifestyle.

Discussion Early use of left ventricular or biventricular mechanical circulatory support may be beneficial as a bridge to transplantation in patients with cardiac AL amyloidosis.

aOnassis Cardiac Surgery Center

bSecond Department of Cardiology, Attikon University Hospital

cFirst Department of Internal Medicine, Laiko Hospital

dDepartment of Cardiology, Mediterraneo Hospital, Athens, Greece

Correspondence to Dimitrios Farmakis, MD, PhD, FESC, First Department of Internal Medicine, University of Athens Medical School, Laiko Hospital, Athens, Greece Tel: +30 210 7456432; fax: +30 210 7788830; e-mail: dimitrios_farmakis@yahoo.com

Received 25 December, 2013

Revised 2 August, 2014

Accepted 13 August, 2014

© 2016 Italian Federation of Cardiology. All rights reserved.