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. 2022 Jun;36(6):e14645.
doi: 10.1111/ctr.14645. Epub 2022 Mar 21.

Heart transplantation in muscular dystrophy: Single-center analysis

Parth Visrodia  1 , Nikhil J Patel  2 , Matthew Burford  3 , Michele A Hamilton  2 , Jignesh K Patel  2 , Jon A Kobashigawa  2 , Michelle M Kittleson  2
Affiliations

Heart transplantation in muscular dystrophy: Single-center analysis

Parth Visrodia et al. Clin Transplant. 2022 Jun.

Abstract

Introduction: Cardiac involvement may occur in many forms of muscular dystrophy (MD). While cardiac disease may progress to warrant heart transplantation (HTx), there may be contraindications related to extra-cardiac disease including pulmonary and skeletal muscle involvement that limit overall survival and impairs post-transplant rehabilitation efforts. This study describes the MD HTx experience at a single high-volume center.

Methods: We examined the clinical characteristics and outcomes of patients with MD with heart failure (HF) (n = 28), patients with MD status post HTx (n = 20) and non-MD HTx control group (n = 40) matched 2:1 for age at transplant, sex, listing status, and antibody sensitization.

Results: Patients with MD who underwent HTx had increased ventilator days (2 vs. 1 days, p = .013), increased hospital length of stay (20 vs. 12 days, p = .022), and increased discharge to inpatient rehab (60% vs. 8%, p < .001). By 1 year post HTx, patients with MD more often required assistive devices for walking (55% vs. 10%, p = .01). Nonetheless, post-HTx survival was similar at 1 year (100% vs. 97.5%, p = .48) and 5 years (95.0% vs. 87.5%, p = .36). Of the HTx recipients with MD, 95% were followed by a neurologist, 60% by a neuromuscular specialist as part of the Muscular Dystrophy Association Clinic at our center.

Conclusion: Transplantation is a feasible option for patients with MD and advanced HF. MD patients who undergo transplantation may benefit from multidisciplinary specialized care to optimize MD-related morbidity.

Keywords: heart failure; heart transplantation; muscular dystrophy.

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References

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