{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:58:45Z","timestamp":1780617525302,"version":"3.54.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Diagnosing cardiac sarcoidosis (CS) is challenging. Immunosuppressive therapies are less effective in end-stage disease, and often heart transplant (HT) is the only available option. We present a series of advanced CS cases, requiring HT, along with a review of the literature evidence in this field.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>Case 1: a 49-year-old man initially suspected of having arrhythmogenic cardiomyopathy (ACM) presented with heart failure (HF) and recurrent ventricular arrhythmias. The rapid clinical deterioration raised suspicion of an inflammatory aetiology, which was confirmed through endomyocardial biopsy, diagnosing CS. Despite immunosuppressive therapy, HT was required. Case 2: a 36-year-old woman presented with high-grade atrioventricular block and dilated cardiomyopathy (DCM), initially diagnosed as idiopathic. Due to worsening HF, she required HT. The pathological examination of the explanted heart revealed CS. Chronic subclinical antibody-mediated rejection was observed after HT. Case 3: a 44-year-old man presented with syncope and imaging suggesting ACM. He was referred for HT due to high ventricular arrhythmic burden. Cardiac sarcoidosis diagnosis was suspected due to pulmonary involvement and then confirmed on post-explant pathological exam. Post-HT pulmonary and cutaneous sarcoidosis reactivation were observed. Case 4: a 43-year-old man was diagnosed with pulmonary sarcoidosis after lung biopsy. Progression towards DCM was observed despite immunosuppressive therapy. Post-HT was characterized by multiple episodes of graft rejection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case series provides insights into mid- and long-term outcomes after HT for CS, highlighting the need for careful management of immunosuppression in these patients, balancing the adverse effects of chronic immunosuppression with the prevention of rejection and sarcoidosis recurrence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae635","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T16:50:27Z","timestamp":1733849427000},"source":"Crossref","is-referenced-by-count":2,"title":["End-stage heart failure and heart transplant in cardiac sarcoidosis: a case series"],"prefix":"10.1093","volume":"8","author":[{"given":"Maria Francesca","family":"Scuppa","sequence":"first","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola Malpighi , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]},{"name":"Department of Medical and Surgical Sciences, University of Bologna , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Accietto","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola Malpighi , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]},{"name":"Department of Medical and Surgical Sciences, University of Bologna , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-7849","authenticated-orcid":false,"given":"Anna","family":"Corsini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola Malpighi , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4250-4859","authenticated-orcid":false,"given":"Maddalena","family":"Graziosi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola Malpighi , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0295-0440","authenticated-orcid":false,"given":"Elena","family":"Biagini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola Malpighi , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Baldovini","sequence":"additional","affiliation":[{"name":"Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Sabatino","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Potena","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Via Massarenti 9, 40138 Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"2024121611505849600_ytae635-B1","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1093\/eurheartj\/ehad067","article-title":"Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis","volume":"44","author":"Lehtonen","year":"2023","journal-title":"Eur Heart J"},{"key":"2024121611505849600_ytae635-B2","doi-asserted-by":"crossref","first-page":"e1197","DOI":"10.1161\/CIR.0000000000001240","article-title":"Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association","volume":"149","author":"Cheng","year":"2024","journal-title":"Circulation"},{"key":"2024121611505849600_ytae635-B3","first-page":"1","article-title":"Management of cardiac sarcoidosis. 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