{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T07:16:24Z","timestamp":1765523784122,"version":"3.48.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac amyloidosis is increasingly recognized as a cause of heart failure. Here we present a case of a heart transplant patient that inadvertently received an allograft with wild-type transthyretin amyloidosis<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 62-year-old man with severe ischaemic biventricular dysfunction underwent an orthotopic heart transplantation. Donor heart details were limited to a report of moderate left ventricular hypertrophy, presumably from chronic hypertension. Post-operatively, the patient did well, but post-transplant imaging was suspicious for an underlying infiltrative cardiomyopathy. Endomyocardial biopsy confirmed that he had inadvertently received an allograft with wild-type transthyretin amyloidosis. Over the subsequent 7 years, he was followed in the Heart Transplant Clinic and was asymptomatic for 5 years post-transplantation. He then gradually developed signs of volume overload with serial imaging showing increased ventricular hypertrophy indicating progression of the cardiac amyloidosis. Subsequently, his condition deteriorated with multiple heart failure hospitalizations, ultimately favouring palliation, and died 7.5 years post-transplantation. Post-mortem autopsy analysis showed extensive allograft amyloid deposition without evidence of rejection or vasculopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This is the first case report of a patient that inadvertently received an allograft with cardiac amyloidosis and provides insight into the natural history of this rare clinical scenario. Based on serial imaging and post-mortem histopathologic analysis, it was clear that there was progression of the underlying cardiac amyloidosis post-transplantation. We hypothesize that this occurred through the process of amyloid seeding. This case highlights the unique clinical and histopathologic findings of cardiac amyloidosis as well as the nuances regarding donor heart selection for transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf607","type":"journal-article","created":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T12:46:45Z","timestamp":1763902005000},"source":"Crossref","is-referenced-by-count":0,"title":["Transplanting the unexpected: a case report of a heart allograft with wild-type transthyretin cardiac amyloid"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9438-4652","authenticated-orcid":false,"given":"Andy","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Cardiac Sciences, Libin Cardiovascular Institute, The University of Calgary , 3310 Hospital Drive NW, Calgary, AB T2N 4N1 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Davey","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Western University , 339 Windermere Rd, London, ON N6A 5A5 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Tweedie","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Western University , 1151 Richmond St, London, ON N6A 5C1 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9236-196X","authenticated-orcid":false,"given":"Stuart","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Western University , 339 Windermere Rd, London, ON N6A 5A5 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"2025121202113117200_ytaf607-B1","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1001\/jama.2024.0442","article-title":"Cardiac amyloidosis due to transthyretin protein: a review","volume":"331","author":"Ruberg","year":"2024","journal-title":"J Am Med Assoc"},{"key":"2025121202113117200_ytaf607-B2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.healun.2022.08.030","article-title":"Donor heart selection: evidence-based guidelines for providers","volume":"42","author":"Copeland","year":"2023","journal-title":"J Heart Lung Transplant"},{"key":"2025121202113117200_ytaf607-B3","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5582\/irdr.2014.01036","article-title":"Cardiac amyloidosis in a heart transplant patient\u2014a case report and retrospective analysis of amyloidosis evolution","volume":"4","author":"Kintsler","year":"2015","journal-title":"Intractable Rare Dis Res"},{"key":"2025121202113117200_ytaf607-B4","doi-asserted-by":"crossref","first-page":"101935","DOI":"10.1016\/j.jaccas.2023.101935","article-title":"Wild-type transthyretin cardiac amyloidosis in a transplanted heart","volume":"19","author":"Stern","year":"2023","journal-title":"JACC Case Rep"},{"key":"2025121202113117200_ytaf607-B5","doi-asserted-by":"crossref","first-page":"e78","DOI":"10.1093\/ehjci\/jeaa294","article-title":"Tacrolimus-induced left ventricular hypertrophy: insights with cardiac magnetic resonance mapping techniques","volume":"22","author":"Mur\u0161i\u0107","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025121202113117200_ytaf607-B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1113\/jphysiol.2002.017129","article-title":"Calcineurin and cardiac hypertrophy: where have we been? 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