LONG-TERM OUTCOME AFTER HEART-TRANSPLANTATION FOR PERIPARTUM CARDIOMYOPATHY

To elucidate the long-term outcome and frequency of complications afte r heart transplantation for peripartum cardiomyopathy (PPCM), we compa red the courses of eight consecutive patients undergoing transplantati on for PPCM with those of nine female age-matched control subjects und ergoing transplantation for idiopathic dilated cardiomyopathy (IDCM). No significant differences could be found in baseline variables betwee n the two groups with the exception of the number of pregnancies (2.5 +/- 1.5 vs 0, p = 0.0002). Two patients in each group died during the first 6 months after transplantation, and one in each group died later . Actuarial survival rates were 75% +/- 15% and 78% +/- 14% (p = NS) a t 1 year and 60% +/- 18% and 78% +/- 14% (p = NS) at 5 years in PPCM a nd IDCM patients, respectively. Linearized rejection rates during the first 3 months were 1.85 +/- 0.56 and 1.91 +/- 0.49 (p = NS) and durin g the second 3 months were 0.18 +/- 0.18 and 0.45 +/- 0.26 (p = NS), r espectively. Similarly no significant differences in linearized infect ion rates were found. Among patients surviving more than 6 months afte r transplantation, after a mean follow-up period of 4.5 +/- 3.1 years for those with PPCM and 7.8 +/- 3.2 years for those with IDCM, 83% and 100%, respectively, were rehabilitated; hemodynamic findings were nor mal in all patients and the frequency of other transplant-associated c omplications was similar in both groups. In conclusion, heart transpla ntation is a valuable option for patients with PPCM and severe congest ive heart failure that is unresponsive to conventional treatment. Long -term survival is favorable and the frequency of transplant-associated complications is comparable to that in age- and sex-matched patients with IDCM.