Rasmusson Kismet D, Stehlik Josef, Brown Robert N, Renlund Dale G, Wagoner Lynne E, Torre-Amione Guillermo, Folsom Jan W, Silber David H, Kirklin James K
UTAH Cardiac Transplant Program, LDS Hospital, Salt Lake City, Utah 84143, USA.
J Heart Lung Transplant. 2007 Nov;26(11):1097-104. doi: 10.1016/j.healun.2007.08.002.
Outcomes of patients with a prior diagnosis of peri-partum cardiomyopathy (PPCM) undergoing heart transplantation are not well described but may be worse than for women who undergo transplantation for other etiologies.
Between 1999 and 2005, 69 women aged younger than 40 underwent transplantation for PPCM in 29 institutions participating in the Cardiac Transplant Research Database. Patients with PPCM were compared with 90 female recipients of similar age with idiopathic dilated cardiomyopathy (IDC) and history of pregnancy (P+), 53 with no prior pregnancy (P-), and with 459 men of a similar age with IDC. Rejection, infection, cardiac allograft vasculopathy, and survival were compared.
Recipients with PPCM accounted for 1% of all transplants and 5% of transplants in women. Comparisons of the 4 patient groups were made. The risk of cumulative rejection was higher in the PPCM Group compared with the P- Group (p < 0.04) and the men (p < 0.0001). Cumulative risk of infection was lowest in the PPCM Group. Freedom from cardiac allograft vasculopathy was similar or higher in the PPCM Group compared with the other groups. Finally, the long-term survival of PPCM patients was comparable with the survival of men (p = 0.9), and there was a trend toward improved survival compared with the P+ Group (p = 0.07) and improved survival compared with the P- Group (p = 0.05).
Heart transplantation for PPCM remains relatively infrequent. Survival and freedom from cardiac allograft vasculopathy in patients who receive a transplant for PPCM are no worse than in women who require a transplant for other indications, regardless of parity.
先前诊断为围产期心肌病（PPCM）的患者接受心脏移植的结果尚未得到充分描述，但可能比因其他病因接受移植的女性更差。
1999年至2005年间，29个参与心脏移植研究数据库的机构中，有69名40岁以下的女性因PPCM接受了移植。将PPCM患者与90名年龄相仿、患有特发性扩张型心肌病（IDC）且有妊娠史（P+）的女性受者、53名无妊娠史（P-）的女性受者以及459名年龄相仿的IDC男性受者进行比较。比较排斥反应、感染、心脏同种异体移植血管病变和生存率。
PPCM受者占所有移植患者的1%，占女性移植患者的5%。对4组患者进行了比较。与P-组（p<0.04）和男性组（p<0.0001）相比，PPCM组累积排斥反应的风险更高。PPCM组感染的累积风险最低。与其他组相比，PPCM组无心脏同种异体移植血管病变的情况相似或更好。最后，PPCM患者的长期生存率与男性相当（p = 0.9），与P+组相比有生存率改善的趋势（p = 0.07），与P-组相比生存率也有所提高（p = 0.05）。
PPCM的心脏移植仍然相对较少。接受PPCM移植的患者的生存率和无心脏同种异体移植血管病变的情况并不比因其他适应症需要移植的女性差，无论其生育情况如何。
