Clinical outcomes after cardiac transplantation in muscular dystrophy patients

Wu, Roland S.; Gupta, Sachin; Brown, Robert N.; Yancy, Clyde W.; Wald, Joyce W.; Kaiser, Patricia; Kirklin, Nicole M.; Patel, Parag C.; Markham, David W.; Drazner, Mark H.; Garry, Daniel J.; Mammen, Pradeep P.A.

doi:10.1016/j.healun.2009.08.030

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 29, Issue 4 , Pages 432-438, April 2010

Clinical outcomes after cardiac transplantation in muscular dystrophy patients

Roland S. Wu, MD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Contributed equally to the manuscript.
Sachin Gupta, MD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Contributed equally to the manuscript.
Robert N. Brown, MS
- Cardiac Transplant Research Database, University of Alabama at Birmingham
Clyde W. Yancy, MD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Current address is Department of Internal Medicine, Baylor University Medical Center
Joyce W. Wald, MD
- Department of Internal Medicine, Temple University
- Current address is Department of Internal Medicine, University of Pennsylvania
Patricia Kaiser, RN
- Department of Internal Medicine, University of Texas Southwestern Medical Center
Nicole M. Kirklin, BA
- Cardiac Transplant Research Database, University of Alabama at Birmingham
Parag C. Patel, MD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center
David W. Markham, MD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center
Mark H. Drazner, MD, MSc
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center
Daniel J. Garry, MD, PhD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center
- Current address is Lillehei Heart Institute, University of Minnesota Medical School
Pradeep P.A. Mammen, MD
- Department of Internal Medicine, University of Texas Southwestern Medical Center
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center
- Reprint requests: Pradeep P. A. Mammen, MD, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, NB10.228, Dallas, TX 75390-8573. Telephone: 214-648-4994. Fax: 214-648-1450

published online 30 October 2009.

Background

Patients with muscular dystrophy are at risk of developing a dilated cardiomyopathy and can progress to advanced heart failure. At present, it is not known whether such patients can safely undergo cardiac transplantation.

Methods

This was a retrospective review of the Cardiac Transplant Research Database, a multi-institutional registry of 29 transplant centers in the United States, from the years 1990 to 2005. The post-cardiac transplant outcomes of 29 patients with muscular dystrophy were compared with 275 non-muscular dystrophy patients with non-ischemic cardiomyopathy, matched for age, body mass index, gender, and race.

Results

Becker's muscular dystrophy was present in 52% of the patients. Survival in the muscular dystrophy patients was similar to the controls at 1 year (89% vs 91%; p = 0.5) and at 5 years (83% vs 78%; p = 0.5). The differences in rates of cumulative infection, rejection, or allograft vasculopathy between the 2 groups were not significant (p > 0.5 for all comparisons).

Conclusions

Recognizing the limitations of the present investigation (ie, selection bias and data lacking in the functional capacity of the muscular dystrophy patients), the current study suggests that the clinical outcomes after cardiac transplantation in selected patients with muscular dystrophy are similar to those seen in age-matched patients with non-ischemic cardiomyopathy.

Keywords: cardiomyopathy, muscular dystrophy, outcome data, retrospective study, transplantation