Peripartum cardiomyopathy: post-transplant outcomes from the United Network for Organ Sharing Database.
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.
Intermountain Medical Center and Intermountain Healthcare, Salt Lake City, Utah 81407, USA. kismet.rasmusson@imail.org
Kismet
K
Rasmusson
Kim
K
Brunisholz
Deborah
D
Budge
Benjamin D
BD
Horne
Rami
R
Alharethi
Jan
J
Folsom
Jenny J
JJ
Connolly
Josef
J
Stehlik
Abdallah
A
Kfoury
D000328:Adult; D009202:Cardiomyopathies / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D016027:Heart Transplantation / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011644:Puerperal Disorders / Q000601:surgery*; D012042:Registries; D016896:Treatment Outcome