Unbound MEDLINE

Peripartum cardiomyopathy: post-transplant outcomes from the United Network for Organ Sharing Database.

Abstract

BACKGROUND
Nearly 25% of patients with peripartum cardiomyopathy (PPCM) will require cardiac transplantation. Whether post-transplant outcomes differ among patients with PPCM compared with other recipients remains unsettled.
METHODS
The United Network for Organ Sharing database was queried for cardiac transplants, comparing characteristics and outcomes for PPCM, other women, and all others.
RESULTS
Between 1987 and 2010, 42,406 patients (9,419 women and 32,987 men) received a heart transplant. Of these, 485 women who had PPCM as the indication were younger (p < 0.001), had higher sensitization (p < 0.001), required higher intensity of cardiovascular support pre-transplant (p = 0.026), and had higher listing status (p < 0.001). Those with PPCM had more post-transplant rejection during the index transplant hospitalization (p < 0.001) and during the first year (p = 0.003). Comparing PPCM with other women and all others, graft survival was inferior (p = 0.004 and p < 0.003, respectively) and age-adjusted survival was lower (p < 0.001 and p = 0.02, respectively).
CONCLUSIONS
This large report shows outcomes of graft failure and death are inferior for recipients with PPCM, which may be partly explained by younger age, higher allosensitization, higher pre-transplant acuity, and increased rejection. More research is needed to determine management strategies to improve outcomes in PPCM heart transplant recipients.

Links

  • Publisher Full Text

    • Authors

    Rasmusson K, Brunisholz K, Budge D, Horne BD, Alharethi R, Folsom J, Connolly JJ, Stehlik J, Kfoury A

    Institution

    Intermountain Medical Center and Intermountain Healthcare, Salt Lake City, Utah 81407, USA. kismet.rasmusson@imail.org

    Source

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 31:2 2012 Feb pg 180-6

    MeSH

    Adult
    Cardiomyopathies
    Female
    Graft Survival
    Heart Transplantation
    Humans
    Male
    Middle Aged
    Pregnancy
    Pregnancy Complications, Cardiovascular
    Puerperal Disorders
    Registries
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22305380