Key result
Anthracycline-induced cardiomyopathy shows no significant increase in post-transplant mortality versus idiopathic dilated cardiomyopathy.
Why the study?
Outcomes after heart transplantation for anthracycline-induced cardiomyopathy remain incompletely characterized, especially compared with idiopathic DCM and ischemic cardiomyopathy.
Does heart transplantation for anthracycline-induced cardiomyopathy result in similar post-transplant mortality compared to idiopathic dilated cardiomyopathy in adult recipients?
Cohort (n=38,897)
Yes
Does heart transplantation for anthracycline-induced cardiomyopathy result in similar post-transplant mortality compared to idiopathic dilated cardiomyopathy in adult recipients?
Hazard Ratio: 1.11 (95% CI 0.98–1.25)
p-value: p=0.111
Heart transplantation for anthracycline-induced cardiomyopathy yields similar survival and graft outcomes to idiopathic dilated cardiomyopathy, though it is associated with increased early post-operative dialysis and long-term malignancy-related mortality.
Supports transplant eligibility in anthracycline cardiomyopathy; leaves open optimal management of dialysis and malignancy risks.
Background: Outcomes after heart transplantation for anthracycline-induced cardiomyopathy (AICM) remain incompletely characterized, particularly compared with idiopathic dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM). Methods: We analyzed adult first-time isolated heart transplant recipients in the Organ Procurement and Transplantation Network/United Network for Organ Sharing registry from January 1, 2000, to September 25, 2025. Recipients were grouped as AICM, idiopathic DCM, or ICM by registry diagnosis. The primary outcome was all-cause post-transplant mortality. Secondary outcomes included graft failure, post-transplant dialysis, stroke, pacemaker implantation, treated rejection, and length of stay. Conclusions: Among selected adult heart transplant recipients, anthracycline-induced cardiomyopathy was not associated with worse post-transplant survival or graft failure compared with idiopathic DCM. However, AICM recipients had higher adjusted odds of post-transplant dialysis, longer index hospitalization, and a greater burden of malignancy-related death, highlighting the need for individualized oncologic and renal-risk assessment in transplant candidates with prior anthracycline exposure.
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Osorio et al. (2026) conducted a cohort in Anthracycline-induced cardiomyopathy requiring heart transplantation (n=38,897). Anthracycline-induced cardiomyopathy vs. Idiopathic dilated cardiomyopathy was evaluated on All-cause post-transplant mortality (HR 1.11, 95% CI 0.98-1.25, p=0.111). Anthracycline-induced cardiomyopathy was not significantly associated with worse post-transplant all-cause mortality compared with idiopathic dilated cardiomyopathy (HR 1.11).
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