Abstract 15112: Heart Transplant Outcomes According to Etiology of Non-ischemic Cardiomyopathies
Objective: We sought to analyze the outcomes and survivals of heart transplant patients according to the etiology of their non-ischemic cardiomyopathies.
Methods: We searched the United Network for Organ Sharing (UNOS) database for all adult patients (age > 18) with NICMP who received orthotropic heart transplant (1995-2013). We identified etiologies and analyzed survival after heart transplant stratified by etiology using Cox proportional hazard model with the following donor and recipient predictors of post-transplant survival: recipient age, dialysis, diabetes mellitus, previous transplant, recipient infection requiring IV drug therapy ≤ 2 weeks pre-transplant, recipient height and weight, bilirubin, creatinine, panel reactive antibody, pulmonary capillary wedge pressure, donor age, donor height and weight, allograft ischemic time.
Results: 14798 patients were transplanted for NICMP: 12476 (84.3%) idiopathic cardiomyopathy (IDCMP), 392 (2.6%) chemotherapy-induced cardiomyopathy (CCMP), 453 (3.1%) peripartum cardiomyopathy (PPCMP), 654 (4.4%) familial cardiomyopathy (FCMP), 193 (1.3%) myocarditis, 147 (1%) alcoholic cardiomyopathy (ACMP) and 483 (3.3%) viral dilated cardiomyopathy (VDCMP). In a Cox proportional hazard model and after adjusting for donor and recipient factors, graft survival for specific etiologies compared with IDCMP were as follows: CCMP (hazard ratio [HR]: 0.95, 95% confidence interval [CI]: 0.71-1.26), PPCMP (HR 0.73, 95% CI:0.57-0.93), FCMP (HR 1.55, 95% CI:1.15-2.08), myocarditis (HR 0.97, 95% CI:0.63-1.50), ACMP (HR 0.7, 95% CI: 0.42-0.78), VDCMP (HR 1.00, 95% CI: 0.82-1.23), figure 1.
Conclusions: Etiology of NICMP carries important survival implications for heart transplant recipients. Better efforts at identifying the etiology of NICMP should be undertaken.
Author Disclosures: S. Al-Kindi: None. A. Younes: None. C. El-Amm: None. M. Ginwalla: None. G.H. Oliveira: None.
- © 2014 by American Heart Association, Inc.