Clinical outcomes after cardiac transplantation in muscular dystrophy patients.
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.
Wu
Roland S
RS
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-8573, USA.
Gupta
Sachin
S
Brown
Robert N
RN
Yancy
Clyde W
CW
Wald
Joyce W
JW
Kaiser
Patricia
P
Kirklin
Nicole M
NM
Patel
Parag C
PC
Markham
David W
DW
Drazner
Mark H
MH
Garry
Daniel J
DJ
Mammen
Pradeep P A
PP
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D020388:Muscular Dystrophy, Duchenne / Q000150:complications*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States