Heart Transplantation Mortality in Recipients with Muscular Dystrophy

PURPOSE We want to compare mortality in heart transplant (HTx) recipients with and without Muscular Dystrophy. METHODS Using the United Network of Organ Sharing (UNOS) Organ Registry we compared mortality rates for HTx recipients with a diagnosis of Muscular Dystrophy (MD), versus HTx recipients without a diagnosis of MD with a multivariate Cox proportional hazard regression model adjusting for age, sex, race, diabetes diagnosis, ischemic time, need for dialysis/life support, recipient wait-time, and HLA mismatch. MD was defined as Becker's Muscular Dystrophy, Emery-Dreifuss Muscular Dystrophy, Duchenne's Muscular Dystrophy, and Other Muscular Dystrophy. We excluded patients who were age <10, lost-to-follow-up, multi-organ transplant and redo transplant recipients. We censored data at 10 years. RESULTS There were a total of 63,051 of non-MD HTx recipients versus 91 MD HTx patients. Non-MD HTx recipients were significantly older versus MD HTx recipients (46.7±19.2 years vs 27.5±14.3 years respectively, p<0.001), had a lower prevalence of diabetes (79.4% vs 97.8% respectively, p<0.001), were less likely to have had prior cardiac surgery (81.7% vs 94.5% respectively, p=0.002), had longer waitlist time (83.0 vs 61.0 days respectively, p =0.013), and were more likely to be a smoker (33.1% vs 11%, p,0.001). The mortality at 10 years was significantly higher for non-MD HTx recipients versus MD HTx recipients (45.9% vs 23.7% respectively, p = 0.0374). CONCLUSION MD HTx patients have higher survival rates compared to NON-MD HTx patients, despite having a higher prevalence of diabetes and prior cardiac surgery.