Heart transplantation in muscular dystrophy: Single-center analysis

Area of Science:

• Cardiology
• Neurology
• Transplantation Medicine

Background:

• Muscular dystrophy (MD) frequently involves cardiac complications, potentially leading to end-stage heart failure requiring heart transplantation (HTx).
• Extra-cardiac manifestations in MD, such as pulmonary and skeletal muscle issues, can pose contraindications and complicate post-transplant recovery.

Purpose of the Study:

• To describe the experience and outcomes of heart transplantation in patients with muscular dystrophy at a high-volume center.
• To evaluate the feasibility and survival rates of HTx in MD patients compared to non-MD controls.

Main Methods:

• Retrospective examination of clinical characteristics and outcomes.
• Comparison of 20 MD patients post-HTx with 28 MD patients with heart failure and 40 non-MD HTx controls.
• Matching of control group for age, sex, listing status, and sensitization.

Main Results:

• MD patients undergoing HTx experienced longer ventilator days and hospital stays, with a higher rate of discharge to inpatient rehabilitation.
• Post-transplant, MD patients more frequently required assistive walking devices.
• Survival rates at 1 and 5 years post-HTx were comparable between MD and non-MD groups.

Conclusions:

• Heart transplantation is a feasible treatment for muscular dystrophy patients with advanced heart failure.
• Multidisciplinary specialized care is essential for managing MD-related morbidities and optimizing outcomes after HTx.