Case characteristics and outcomes of idiopathic giant cell myocarditis after heart transplantation
10.3760/cma.j.cn421203-20220830-00221
- VernacularTitle:特发性巨细胞性心肌炎行心脏移植术12例受者病例特点及预后研究
- Author:
Xiaoying HU
1
;
Zhongkai LIAO
;
Hui SUN
;
Jie HUANG
;
Sheng LIU
;
Wei WANG
;
Yunhu SONG
;
Shengshou HU
;
Hongyue WANG
;
Zhe ZHENG
Author Information
1. 国家心血管病中心 中国医学科学院阜外医院心内科，北京 100037
- Keywords:
Heart transplantation;
Idiopathic giant cell myocarditis;
Prognosis
- From:
Chinese Journal of Organ Transplantation
2022;43(12):718-722
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the case characteristics and outcomes of 12 idiopathic giant cell myocarditis(IGCM)cases after heart transplantation(HT).Methods:From June 2004 to May 2022, clinical data were retrospectively reviewed for 12 cases with pathologically confirm IGCM after HT at Fuwai Hospital.General characteristics, clinical manifestations, pathological examinations and postoperative follow-ups are recorded.Results:From June 2004 to May 2022, a total of 1 143 HT operations are performed at Fuwai Hospital and 12 cases of IGCM(1.05%)are confirmed by postoperative pathology.The age is(47.6±7.3)years.There are 5 boys and 7 girls.Initial presenting manifestations are congestive heart failure(7 cases, 58.3%)and arrhythmia(4 cases, 33.3%). Median time from symptom onset to HT is 6 months.All of them are undiagnosed pre-operation.And dilated cardiomyopathy(5 cases, 41.7%)and arrhythmogenic right ventricular cardiomyopathy(3 cases, 25%)are confirmed.The follow-up period is(4~142)months post-HT.One death occurred during perioperative period and another is due to heart failure at 68 months post-HT.Only 1 case of grade 1R transplant heart rejection occurrs at 9 years post-HT and there is no case of recurrence.According to Kaplan-Meier survival analysis, cumulative survival rates of 1/5/10 years post-HT in IGCM patients are 91.7%, 91.7% and 73.3% respectively.No significant difference exist in survival rate for other etiologies post-HT(Log-rank P=0.265). Conclusions:HT is efficacious for end-stage IGCM.Regular and sufficient postoperative immunosuppression is vital for preventing heart transplant rejection and recurrent IGCM.Most IGCM patients have a decent prognosis post-HT.
