Type of heart disease affects survival on transplant waiting list

20th June 2016

People with hypertrophic and dilated cardiomyopathy survive better than others on heart transplant waiting lists in America, say a group of researchers.

But those with restrictive cardiomyopathy were among people who did less well, so they should have greater priority for new hearts, recommended the researchers in a recent publication in the American College of Cardiology’s journal Heart Failure.

They suggested the allocation system should be revised to reflect the differences in survival.

The researchers looked at data from more than 30,000 American people with heart failure waiting for a transplant between 2004 and 2014.  During a median follow-up of 43 months nearly 5,000 patients had died.

The statistics showed those with the highest risk of dying while they waited were people with restrictive cardiomyopathy, a previous heart transplant and those born with problems in the heart’s structure.

Those with the lowest risk were people with dilated cardiomyopathy, hypertrophic cardiomyopathy, coronary artery disease and valve disease.

The study was led by Dr Eileen Hsich, an associate director of the heart transplant programme at the Cleveland Clinic.  It included colleagues in Cleveland and at the Duke University and the University of Pittsburgh Medical Centre.

Gender also played a role. Women with restrictive cardiomyopathy were at significantly lower risk of dying on the waiting list than men with the same disease, but at higher risk if they had coronary artery disease.

The current heart transplant allocation system is based on severity of disease.

“Our data supports a change in the allocation system to prioritise restrictive cardiomyopathy, congenital heart disease and prior heart transplantation over other types of heart disease,” Dr. Hsich said

But she said further research was needed to better define the risk factors for these and other subgroups of heart disease.

For more details, see here.https://consultqd.clevelandclinic.org/2016/06/type-underlying-heart-disease-shapes-survival-transplant-wait-list/