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Semin Respir Crit Care Med 2017; 38(04): 538-545
DOI: 10.1055/s-0037-1602383
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Solid Organ Transplantation in Sarcoidosis

J. Yserbyt
1   Department of Clinical and Experimental Medicine, Lab of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Leuven, Belgium
2   Department of Respiratory Medicine, Lung Transplant and Respiratory Intermediate Care Unit, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
W. A. Wuyts
1   Department of Clinical and Experimental Medicine, Lab of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Leuven, Belgium
2   Department of Respiratory Medicine, Lung Transplant and Respiratory Intermediate Care Unit, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
S. E. Verleden
1   Department of Clinical and Experimental Medicine, Lab of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Leuven, Belgium
2   Department of Respiratory Medicine, Lung Transplant and Respiratory Intermediate Care Unit, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
G. M. Verleden
1   Department of Clinical and Experimental Medicine, Lab of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Leuven, Belgium
2   Department of Respiratory Medicine, Lung Transplant and Respiratory Intermediate Care Unit, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
D. E. Van Raemdonck
3   Department of Experimental Thoracic Surgery, Department of Thoracic Surgery, KU Leuven and University Hospitals Leuven, Leuven, Belgium
,
E. K. Verbeken
4   Department of Histopathology, KU Leuven, Leuven, Belgium
,
B. M. Vanaudenaerde
1   Department of Clinical and Experimental Medicine, Lab of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Leuven, Belgium
2   Department of Respiratory Medicine, Lung Transplant and Respiratory Intermediate Care Unit, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
R. Vos
1   Department of Clinical and Experimental Medicine, Lab of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Leuven, Belgium
2   Department of Respiratory Medicine, Lung Transplant and Respiratory Intermediate Care Unit, University Hospitals Leuven, KU Leuven, Leuven, Belgium
› Author Affiliations
Further Information

Publication History

Publication Date:
27 July 2017 (online)

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Abstract

Sarcoidosis is a chronic systemic inflammatory disease which is histopathologically characterized by the presence of noncaseating granulomas. When the extent of the disease is limited, without endangering the function of affected organs, clinical observation can be sufficient given that in a majority of cases, inflammation will subside with time. In more advanced sarcoidosis, especially when one or more specific organs are threatened, immunomodulatory treatment, of which steroids are the key element, over a prolonged period of time, in general, may attenuate disease activity. Treatment-refractory sarcoidosis (due to the lack of efficacy, drug toxicity or intolerability) may be progressive and, although infrequent, can result in end-stage organ failure. In these selected cases, solid organ transplantation (SOT) should be considered. In this article, SOT is positioned within the organ-specific treatment of systemic sarcoidosis and data on outcome after transplantation are discussed.

Keywords

heart transplantation - kidney transplantation - lung transplantation - orthotopic liver transplantation - sarcoidosis - outcome
 

  • References

  • 1 Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J. Sarcoidosis. Lancet 2014; 383 (9923): 1155-1167
    CrossrefPubMedGoogle Scholar
  • 2 Wijsenbeek MS, Culver DA. Treatment of sarcoidosis. Clin Chest Med 2015; 36 (04) 751-767
    PubMedGoogle Scholar
  • 3 Al-Kofahi K, Korsten P, Ascoli C. , et al. Management of extrapulmonary sarcoidosis: challenges and solutions. Ther Clin Risk Manag 2016; 12: 1623-1634
    CrossrefPubMedGoogle Scholar
  • 4 Hunninghake GW, Costabel U, Ando M. , et al. ATS/ERS/WASOG statement on sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 1999; 16 (02) 149-173
    PubMedGoogle Scholar
  • 5 Orens JB, Estenne M, Arcasoy S. , et al; Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. International guidelines for the selection of lung transplant candidates: 2006 update--a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2006; 25 (07) 745-755
    CrossrefPubMedGoogle Scholar
  • 6 Shah PD, Orens JB. Guidelines for the selection of lung-transplant candidates. Curr Opin Organ Transplant 2012; 17 (05) 467-473
    CrossrefPubMedGoogle Scholar
  • 7 Weill D, Benden C, Corris PA. , et al. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2015; 34 (01) 1-15
    CrossrefPubMedGoogle Scholar
  • 8 Valapour M, Skeans MA, Smith JM. , et al. OPTN/SRTR 2015 Annual Data Report: lung. Am J Transplant 2017; 17 (Suppl. 01) 357-424
    CrossrefPubMedGoogle Scholar
  • 9 Patterson KC, Strek ME. Pulmonary fibrosis in sarcoidosis. Clinical features and outcomes. Ann Am Thorac Soc 2013; 10 (04) 362-370
    CrossrefPubMedGoogle Scholar
  • 10 Liu Y, Liu Y, Su L, Jiang SJ. Recipient-related clinical risk factors for primary graft dysfunction after lung transplantation: a systematic review and meta-analysis. PLoS One 2014; 9 (03) e92773
    CrossrefPubMedGoogle Scholar
  • 11 Hong A, King CS, Brown AWW. , et al. Hemothorax following lung transplantation: incidence, risk factors, and effect on morbidity and mortality. Multidiscip Respir Med 2016; 11: 40
    CrossrefPubMedGoogle Scholar
  • 12 Yusen RD, Edwards LB, Kucheryavaya AY. , et al; International Society for Heart and Lung Transplantation. The registry of the International Society for Heart and Lung Transplantation: thirty-first adult lung and heart-lung transplant report--2014; focus theme: retransplantation. J Heart Lung Transplant 2014; 33 (10) 1009-1024
    CrossrefPubMedGoogle Scholar
  • 13 Shorr AF, Helman DL, Davies DB, Nathan SD. Sarcoidosis, race, and short-term outcomes following lung transplantation. Chest 2004; 125 (03) 990-996
    CrossrefPubMedGoogle Scholar
  • 14 Shlobin OA, Nathan SD. Management of end-stage sarcoidosis: pulmonary hypertension and lung transplantation. Eur Respir J 2012; 39 (06) 1520-1533
    CrossrefPubMedGoogle Scholar
  • 15 Walker S, Mikhail G, Banner N. , et al. Medium term results of lung transplantation for end stage pulmonary sarcoidosis. Thorax 1998; 53 (04) 281-284
    CrossrefPubMedGoogle Scholar
  • 16 Arcasoy SM, Christie JD, Pochettino A. , et al. Characteristics and outcomes of patients with sarcoidosis listed for lung transplantation. Chest 2001; 120 (03) 873-880
    CrossrefPubMedGoogle Scholar
  • 17 Taimeh Z, Hertz MI, Shumway S, Pritzker M. Lung transplantation for pulmonary sarcoidosis. Twenty-five years of experience in the USA. Thorax 2016; 71 (04) 378-379
    CrossrefPubMedGoogle Scholar
  • 18 Wille KM, Gaggar A, Hajari AS. , et al. Bronchiolitis obliterans syndrome and survival following lung transplantation for patients with sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2008; 25 (02) 117-124
    PubMedGoogle Scholar
  • 19 Collins J, Hartman MJ, Warner TF. , et al. Frequency and CT findings of recurrent disease after lung transplantation. Radiology 2001; 219 (02) 503-509
    CrossrefPubMedGoogle Scholar
  • 20 Ionescu DN, Hunt JL, Lomago D, Yousem SA. Recurrent sarcoidosis in lung transplant allografts: granulomas are of recipient origin. Diagn Mol Pathol 2005; 14 (03) 140-145
    CrossrefPubMedGoogle Scholar
  • 21 Schultz HH, Andersen CB, Steinbruuchel D, Perch M, Carlsen J, Iversen M. Recurrence of sarcoid granulomas in lung transplant recipients is common and does not affect overall survival. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31 (02) 149-153
    PubMedGoogle Scholar
  • 22 Banga A, Sahoo D, Lane CR, Farver CF, Budev MM. Disease recurrence and acute cellular rejection episodes during the first year after lung transplantation among patients with sarcoidosis. Transplantation 2015; 99 (09) 1940-1945
    CrossrefPubMedGoogle Scholar
  • 23 Bjørtuft O, Foerster A, Boe J, Geiran O. Single lung transplantation as treatment for end-stage pulmonary sarcoidosis: recurrence of sarcoidosis in two different lung allografts in one patient. J Heart Lung Transplant 1994; 13 (1 Pt 1): 24-29
    PubMedGoogle Scholar
  • 24 Baughman RP, Teirstein AS, Judson MA. , et al; A Case Control Etiologic Study of Sarcoidosis (ACCESS) research group. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001; 164 (10 Pt 1): 1885-1889
    CrossrefPubMedGoogle Scholar
  • 25 Baughman RP, Janovcik J, Ray M, Sweiss N, Lower EE. Calcium and vitamin D metabolism in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30 (02) 113-120
    PubMedGoogle Scholar
  • 26 Bagnasco SM, Gottipati S, Kraus E. , et al. Sarcoidosis in native and transplanted kidneys: incidence, pathologic findings, and clinical course. PLoS One 2014; 9 (10) e110778
    CrossrefPubMedGoogle Scholar
  • 27 Löffler C, Löffler U, Tuleweit A, Waldherr R, Uppenkamp M, Bergner R. Renal sarcoidosis: epidemiological and follow-up data in a cohort of 27 patients. Sarcoidosis Vasc Diffuse Lung Dis 2015; 31 (04) 306-315
    PubMedGoogle Scholar
  • 28 Mahévas M, Lescure FX, Boffa JJ. , et al. Renal sarcoidosis: clinical, laboratory, and histologic presentation and outcome in 47 patients. Medicine (Baltimore) 2009; 88 (02) 98-106
    CrossrefPubMedGoogle Scholar
  • 29 Hilderson I, Van Laecke S, Wauters A, Donck J. Treatment of renal sarcoidosis: is there a guideline? Overview of the different treatment options. Nephrol Dial Transplant 2014; 29 (10) 1841-1847
    CrossrefPubMedGoogle Scholar
  • 30 Mann DM, Fyfe B, Osband AJ. , et al. Sarcoidosis within a renal allograft: a case report and review of the literature. Transplant Proc 2013; 45 (02) 838-841
    CrossrefPubMedGoogle Scholar
  • 31 Aouizerate J, Matignon M, Kamar N. , et al. Renal transplantation in patients with sarcoidosis: a French multicenter study. Clin J Am Soc Nephrol 2010; 5 (11) 2101-2108
    CrossrefPubMedGoogle Scholar
  • 32 Kandolin R, Lehtonen J, Airaksinen J. , et al. Cardiac sarcoidosis: epidemiology, characteristics, and outcome over 25 years in a nationwide study. Circulation 2015; 131 (07) 624-632
    CrossrefPubMedGoogle Scholar
  • 33 Iwai K, Tachibana T, Takemura T, Matsui Y, Kitaichi M, Kawabata Y. Pathological studies on sarcoidosis autopsy. I. Epidemiological features of 320 cases in Japan. Acta Pathol Jpn 1993; 43 (7-8): 372-376
    PubMedGoogle Scholar
  • 34 Roberts WC, Roberts CC, Ko JM, Filardo G, Capehart JE, Hall SA. Morphologic features of the recipient heart in patients having cardiac transplantation and analysis of the congruence or incongruence between the clinical and morphologic diagnoses. Medicine (Baltimore) 2014; 93 (05) 211-235
    CrossrefPubMedGoogle Scholar
  • 35 Lynch III JP, Hwang J, Bradfield J, Fishbein M, Shivkumar K, Tung R. Cardiac involvement in sarcoidosis: evolving concepts in diagnosis and treatment. Semin Respir Crit Care Med 2014; 35 (03) 372-390
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Nagai S, Yokomatsu T, Tanizawa K. , et al. Treatment with methotrexate and low-dose corticosteroids in sarcoidosis patients with cardiac lesions. Intern Med 2014; 53 (05) 427-433
    CrossrefPubMedGoogle Scholar
  • 37 Roberts WC, McAllister Jr HA, Ferrans VJ. Sarcoidosis of the heart. A clinicopathologic study of 35 necropsy patients (group 1) and review of 78 previously described necropsy patients (group 11). Am J Med 1977; 63 (01) 86-108
    CrossrefPubMedGoogle Scholar
  • 38 Fleming HA, Bailey SM. The prognosis of sarcoid heart disease in the United Kingdom. Ann N Y Acad Sci 1986; 465: 543-550
    CrossrefPubMedGoogle Scholar
  • 39 Yazaki Y, Isobe M, Hiroe M. , et al; Central Japan Heart Study Group. Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone. Am J Cardiol 2001; 88 (09) 1006-1010
    CrossrefPubMedGoogle Scholar
  • 40 Okura Y, Dec GW, Hare JM. , et al. A clinical and histopathologic comparison of cardiac sarcoidosis and idiopathic giant cell myocarditis. J Am Coll Cardiol 2003; 41 (02) 322-329
    PubMedGoogle Scholar
  • 41 Chiu CZ, Nakatani S, Zhang G. , et al. Prevention of left ventricular remodeling by long-term corticosteroid therapy in patients with cardiac sarcoidosis. Am J Cardiol 2005; 95 (01) 143-146
    CrossrefPubMedGoogle Scholar
  • 42 Kato Y, Morimoto S, Uemura A, Hiramitsu S, Ito T, Hishida H. Efficacy of corticosteroids in sarcoidosis presenting with atrioventricular block. Sarcoidosis Vasc Diffuse Lung Dis 2003; 20 (02) 133-137
    PubMedGoogle Scholar
  • 43 Chapelon-Abric C, de Zuttere D, Duhaut P. , et al. Cardiac sarcoidosis: a retrospective study of 41 cases. Medicine (Baltimore) 2004; 83 (06) 315-334
    CrossrefPubMedGoogle Scholar
  • 44 Patel MR, Cawley PJ, Heitner JF. , et al. Detection of myocardial damage in patients with sarcoidosis. Circulation 2009; 120 (20) 1969-1977
    CrossrefPubMedGoogle Scholar
  • 45 Greulich S, Deluigi CC, Gloekler S. , et al. CMR imaging predicts death and other adverse events in suspected cardiac sarcoidosis. JACC Cardiovasc Imaging 2013; 6 (04) 501-511
    CrossrefPubMedGoogle Scholar
  • 46 Mehta D, Lubitz SA, Frankel Z. , et al. Cardiac involvement in patients with sarcoidosis: diagnostic and prognostic value of outpatient testing. Chest 2008; 133 (06) 1426-1435
    CrossrefPubMedGoogle Scholar
  • 47 Valantine HA, Tazelaar HD, Macoviak J. , et al. Cardiac sarcoidosis: response to steroids and transplantation. J Heart Transplant 1987; 6 (04) 244-250
    PubMedGoogle Scholar
  • 48 Theofilogiannakos EK, Pettit SJ, Ghazi A, Rassl D, Lewis C, Parameshwar J. Heart transplantation for advanced heart failure due to cardiac sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2015; 32 (03) 208-214
    PubMedGoogle Scholar
  • 49 Perkel D, Czer LSC, Morrissey RP. , et al. Heart transplantation for end-stage heart failure due to cardiac sarcoidosis. Transplant Proc 2013; 45 (06) 2384-2386
    CrossrefPubMedGoogle Scholar
  • 50 Al-Kindi SG, Oliveira GH. Letter by Al-Kindi and Oliveira regarding article “cardiac sarcoidosis: epidemiology, characteristics, and outcome over 25 years in a nationwide study”. Circulation 2015; 132 (17) e211
    CrossrefPubMedGoogle Scholar
  • 51 Oni AA, Hershberger RE, Norman DJ. , et al. Recurrence of sarcoidosis in a cardiac allograft: control with augmented corticosteroids. J Heart Lung Transplant 1992; 11 (2 Pt 1): 367-369
    PubMedGoogle Scholar
  • 52 Khan R, Tweedie EJ, Pflugfelder PW, White JA. Cardiac sarcoid in a heart transplant recipient: detection with cardiac magnetic resonance imaging. Transplant Proc 2010; 42 (05) 1976-1978
    CrossrefPubMedGoogle Scholar
  • 53 Luk A, Lee A, Ahn E, Soor GS, Ross HJ, Butany J. Cardiac sarcoidosis: recurrent disease in a heart transplant patient following pulmonary tuberculosis infection. Can J Cardiol 2010; 26 (07) e273-e275
    CrossrefPubMedGoogle Scholar
  • 54 Modaresi Esfeh J, Culver D, Plesec T, John B. Clinical presentation and protocol for management of hepatic sarcoidosis. Expert Rev Gastroenterol Hepatol 2015; 9 (03) 349-358
    CrossrefPubMedGoogle Scholar
  • 55 Vatti R, Sharma OP. Course of asymptomatic liver involvement in sarcoidosis: role of therapy in selected cases. Sarcoidosis Vasc Diffuse Lung Dis 1997; 14 (01) 73-76
    PubMedGoogle Scholar
  • 56 Ebert EC, Kierson M, Hagspiel KD. Gastrointestinal and hepatic manifestations of sarcoidosis. Am J Gastroenterol 2008; 103 (12) 3184-3192 , quiz 3193
    CrossrefPubMedGoogle Scholar
  • 57 Valla D, Pessegueiro-Miranda H, Degott C, Lebrec D, Rueff B, Benhamou JP. Hepatic sarcoidosis with portal hypertension. A report of seven cases with a review of the literature. Q J Med 1987; 63 (242) 531-544
    PubMedGoogle Scholar
  • 58 Malhotra A, Naniwadekar A, Sood G. Hepatobiliary and pancreatic: cirrhosis secondary to hepatic sarcoidosis. J Gastroenterol Hepatol 2008; 23 (12) 1942
    CrossrefPubMedGoogle Scholar
  • 59 Tadros M, Forouhar F, Wu GY. Hepatic sarcoidosis. J Clin Transl Hepatol 2013; 1 (02) 87-93
    PubMedGoogle Scholar
  • 60 Bilal M, Satapathy SK, Ismail MK, Vanatta JM. Long-term outcomes of liver transplantation for hepatic sarcoidosis: a single center experience. J Clin Exp Hepatol 2016; 6 (02) 94-99
    CrossrefPubMedGoogle Scholar
  • 61 Vanatta JM, Modanlou KA, Dean AG. , et al. Outcomes of orthotopic liver transplantation for hepatic sarcoidosis: an analysis of the United Network for Organ Sharing/Organ Procurement and Transplantation Network data files for a comparative study with cholestatic liver diseases. Liver Transpl 2011; 17 (09) 1027-1034
    PubMedGoogle Scholar
  • 62 Lipson EJ, Fiel MI, Florman SS, Korenblat KM. Patient and graft outcomes following liver transplantation for sarcoidosis. Clin Transplant 2005; 19 (04) 487-491
    CrossrefPubMedGoogle Scholar
  • 63 Fidler HM, Hadziyannis SJ, Dhillon AP, Sherlock S, Burroughs AK. Recurrent hepatic sarcoidosis following liver transplantation. Transplant Proc 1997; 29 (05) 2509-2510
    CrossrefPubMedGoogle Scholar