1. Peripartum cardiomyopathy: Post-transplant outcomes from the united network for organ sharing database
- Author
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Rasmusson, Kismet, Brunisholz, Kim, Budge, Deborah, Horne, Benjamin D., Alharethi, Rami, Folsom, Jan, Connolly, Jenny J., Stehlik, Josef, and Kfoury, Abdallah
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CARDIOMYOPATHIES , *HEART transplantation , *CARDIOVASCULAR diseases , *HOSPITAL care , *HEALTH outcome assessment , *DATABASES - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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