Long‐term post‐transplantation outcomes in patients with hypertrophic cardiomyopathy: Single‐center 35‐year experience

• DOI: 10.1111/ctr.15265
• Publication Date: 2024-02-21T12:25:16Z
• Authors: Matylda Mazur; Geetha Bhat; Eric Popjes; Robert Dowling; Howard J. Eisen
• Keywords: 03 medical and health sciences; 0302 clinical medicine

AbstractBackgroundHeart transplantation (HT) is the only option for most patients with end‐stage heart failure and hypertrophic cardiomyopathy (HCM) who fail medical therapy. Data on the long‐term outcomes post‐transplant in HCM individuals remain scarce.MethodsWe analyzed data of 319 adult patients who underwent HT between 1984 and 2019. Patients were followed for cardiac allograft rejection, cardiac allograft vasculopathy (CAV), death, or re‐transplantation.ResultsOutcomes of 24 patients with HCM, 160 with ischemic, and 135 with dilated cardiomyopathy were compared. During a mean follow‐up of 11.6 ± 7.2 (max 27.8), 16.7 ± 8.2 (max 32.7), and 16.1 ± 9.7 (max 34.6) years after HT in hypertrophic, ischemic, and dilated cardiomyopathy groups, respectively: 10‐year survival rate was 67%, 62%, 69%, respectively (p = .04). Post‐transplantation, HCM individuals more often than the other two studied groups required prolonged inotropic support (37%, 12%, 17%, respectively, p = .02), temporary mechanical circulatory support (45%, 13%, 14%, respectively, p < .01), and renal replacement therapy immediately post‐HT (55%, 19%, 24%, respectively, p < .01). No significant inter‐group differences were noted in the 10‐year freedom from acute allograft rejection (38%, 46%, 43%, respectively, p = .38) or 10‐year freedom from CAV (88%, 78%, 81%, respectively, p = .57).ConclusionsThe long‐term post‐transplant prognosis of adult patients with hypertrophic cardiomyopathy is favorable despite more challenging immediate post‐HT course.