Cardiac sarcoidosis recurrence post-heart transplant: A critical literature and case report

Andrea Salotti; Lucrezia Mondini; Paola Confalonieri; Francesco Salton; Chiara Nalli; Nicolò Reccardini; Chiara Torregiani; Caterina Antonaglia; Michael Hughes; Marco Confalonieri; Rossella Cifaldi; Barbara Ruaro

doi:10.36141/svdld.v42i3.16865

Authors

Andrea Salotti Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Lucrezia Mondini Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Paola Confalonieri Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Francesco Salton Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Chiara Nalli Cardiothoracic Department, University Hospital of Udine, Udine, Italy
Nicolò Reccardini Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Chiara Torregiani Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Caterina Antonaglia Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Michael Hughes Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Salford Royal NHS Foundation Trust, Mancheste, UK
Marco Confalonieri Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Rossella Cifaldi Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Barbara Ruaro Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy

Keywords:

Cardiac sarcoidosis, post-transplant recurrence, immunosuppressive therapies, Positron Emission Computed Tomography (PET-CT), Cardiac Magnetic Resonance (CMR), endomyocardial biopsy

Abstract

Background and aim: Recurrence of cardiac sarcoidosis (CS) following heart transplantation (HT) is a rare but clinically significant complication that influences management strategies and prognosis. This review examines existing evidence on the diagnosis and treatment of post-transplant CS recurrence. Additionally, we present a case report of CS recurrence in a patient after HT.

Methods: We analyzed clinical studies, case reports, and systematic reviews published up to January 2025, focusing on the recurrence of CS after transplantation.

Results: Limited data suggest that immunosuppressive therapies are crucial in managing post-transplant CS recurrence. Diagnosis relies on imaging modalities such as Positron Emission Tomography (PET-CT), Cardiac Magnetic Resonance (CMR), and endomyocardial biopsies. Treatment generally involves intensifying immunosuppressive therapy.

Conclusions: Standardized guidelines are essential to improve the management of this rare and complex condition and to enhance long-term patient outcomes.

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