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Di Nora et al. Vessel Plus 2022;6:46 Vessel Plus
DOI: 10.20517/2574-1209.2021.126

Review Open Access

Heart transplantation in cardiac amyloidosis

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Concetta Di Nora , Sandro Sponga , Chiara Nalli , Mauro Driussi , Igor Vendramin , Giovanni Benedetti ,
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Giorgio Guzzi , Massimo Imazio , Ugolino Livi 1
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Department of Cardiothoracic Science, Azienda Sanitaria Universitaria Integrata di Udine, Hospital S. Maria della Misericordia,
Udine 33100, Italy.
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Cardiology Department, Azienda Sanitaria Universitaria Integrata di Udine, Udine 33100 Italy.
Correspondence to: Concetta Di Nora, Department of Cardiothoracic Science, Azienda Sanitaria Universitaria Integrata di Udine,
Hospital S. Maria della Misericordia, Udine 33100, Italy. E-mail: concetta.dinora@gmail.com.
How to cite this article: Di Nora C, Sponga S, Nalli C, Driussi M, Vendramin I, Benedetti G, Guzzi G, Imazio M, Livi U. Heart
transplantation in cardiac amyloidosis. Vessel Plus 2022;6:46. https://dx.doi.org/10.20517/2574-1209.2021.126
Received: 30 Sep 2021 First Decision: 13 Jan 2022 Revised: 10 Feb 2022 Accepted: 1 Mar 2022 Published: 1 Aug 2022
Academic Editor: Francesco Nappi Copy Editor: Jia-Xin Zhang Production Editor: Jia-Xin Zhang

Abstract
It is known that the prognosis of patients affected by light-chain (AL) or transthyretin-related (TTR) amyloidosis is
poor. TTR amyloidosis has usually shown a slower progression than AL amyloidosis, both hereditary TTR
amyloidosis, where there is an inherited mutation in the DNA, and wild-type TTR amyloidosis, which usually affects
the elderly. In this paper, the current literature about heart transplantation on cardiac amyloidosis patients is
extensively reviewed. The two most frequent types of cardiac amyloidosis have been considered for heart
transplantation: AL amyloidosis and wild-type TTR amyloidosis. According to this analysis, it is reasonable that
heart transplantation may represent a valuable option in carefully selected patients. Moreover, it could improve
prognosis, enabling autologous stem cell transplantation in the AL amyloidosis subgroup. In our humble opinion, it
is mandatory to define a multidisciplinary approach to help select candidates to obtain the most effective results.

Keywords: Heart transplantation, cardiac amyloidosis, prognosis

INTRODUCTION
Heart transplantation (HTx) is the leading option for advanced heart failure (HF) patients; however, some
issues must be considered when HF is secondary to systemic diseases with predominant heart involvement.
Thus, screening for HTx involves a complete screening to exclude important co-pathologies that can
worsen the short-term outcome or the long-term survival.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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