Patients with congestive cardiomyopathy as cardiac transplant recipients. Indications for and results of cardiac transplantation and comparison with patients with coronary artery disease.
In recent years end-stage congestive cardiomyopathy has become an increasingly frequent clinical diagnosis in candidates for cardiac transplantation. Forty-six patients who underwent transplantation because of congestive cardiomyopathy and 59 because of coronary artery disease were studied between 1971 and 1978 at Stanford University. The overall 1 year survival rate was similar in the two groups: cardiomyopathy-transplant, 64 percent and coronary artery disease-transplant, 55 percent. The survival rate has improved substantially for both groups within the last decade: The 3 year survival rate for cardiomyopathy-transplant patients undergoing cardiac transplantation since 1974 is nearly 60 percent. In contrast, 36 similarly ill patients with cardiomyopathy not undergoing transplantation had a 1 year survival rate of 23 percent and a 3 year survival rate of 4 percent (p less than 0.001). Survival rates in the cardiomyopathy-transplant group were unaffected by age (greater or less than 40 years). Patients in this group under age 40 had a lower frequency of infection (1 per 313 patient-days versus 1 per 195 patient-days in the older group, p less than 0.05) and a significantly longer interval to second rejection episodes (p less than 0.05), a measure of rejection frequency. Cardiomyopathy-transplant patients under age 40 had fewer deaths due to rejection (17 percent) compared with older patients in this group (36 percent). Cardiac transplantation is an effective treatment for end-stage congestive cardiomyopathy.
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000209:etiology; D009202:Cardiomyopathies / Q000401:mortality / Q000534:rehabilitation / Q000628:therapy*; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D014184:Transplantation, Homologous