Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T18:20:45.979Z Has data issue: false hasContentIssue false

The importance of preconception and prenatal genetic evaluation in heart transplant individuals and fetal and postnatal cardiac monitoring in their offspring

Published online by Cambridge University Press:  19 July 2018

Yin Liu*
Affiliation:
Department of Pediatrics, Division of Child Neurology, Loma Linda University Children’s Hospital, Loma Linda, CA, USA
Matthew J. Bock
Affiliation:
Department of Pediatrics, Division of Cardiology, Loma Linda University Children’s Hospital, Loma Linda, CA, USA
June-Anne Gold
Affiliation:
Department of Pediatrics, Division of Pediatric Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA, USA
*
Author for correspondence: Y. Liu, MD, PhD, Department of Pediatrics, Division of Child Neurology, Loma Linda University Children’s Hospital, 11175 Campus Street, Coleman Pavilion Suite 11121, Loma Linda, CA 92354, USA. Tel: 909 651 5746; Fax: 909 558 0298; E-mail: liuyinscmc@gmail.com

Abstract

A 24-year-old woman with a history of idiopathic dilated cardiomyopathy status post heart transplant gave birth to a healthy term female infant. At 5 months of age, the infant was diagnosed with severe left ventricular dysfunction with an ejection fraction of 18% and moderate non-compaction of the left ventricle. She received a heart transplant at 7 months of age. Familial dilated cardiomyopathy was diagnosed. Genetic testing revealed a likely pathogenic variant in the TPM1 gene. Fetal cardiac screening is critical for offspring of heart transplant recipients, especially when the reason for transplant was cardiomyopathy. Early genetic consultation and counselling is necessary for all heart transplant recipients, preferably prenatally. Postnatal screening of offspring is essential at birth, at 3-month intervals until 1 year of age, and then annually until the risk for familial cardiomyopathy is assessed.

Type
Brief Report
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Deutsch, MA, Kaczmarek, I, Huber, S, et al. Sirolimus-associated infertility: case report and literature review of possible mechanisms. Am J Transplant 2007; 7: 24142421.Google Scholar
2. Sifontis, NM, Coscia, LA, Constantinescu, S, Lavelanet, AF, Moritz, MJ, Armenti, VT. Pregnancy outcomes in solid organ transplant recipients with exposure to mycophenolate mofetil or sirolimus. Transplantation 2006; 82: 16981702.Google Scholar
3. Fiocchi, R, D’Elia, E, Vittori, C, et al. First report of a successful pregnancy in an everolimus-treated heart-transplanted patient: neonatal disappearance of immunosuppressive drugs. Am J Transplant 2016; 16: 13191322.Google Scholar
4. Solomon, BD, Muenke, M. When to suspect a genetic syndrome. Am Fam Physician 2012; 86: 826833.Google Scholar
5. Kini, U, Adab, N, Vinten, J, et al. Dysmorphic features: an important clue to the diagnosis and severity of fetal anticonvulsant syndromes. Arch Dis Child Fetal Neonatal Ed 2006; 91: F90F95.Google Scholar
6. Leroy, C, Rigot, JM, Leroy, M, et al. Immunosuppressive drugs and fertility. Orphanet J Rare Dis 2015; 10: 136.Google Scholar
7. Abdalla, M, Mancini, DM. Management of pregnancy in the post-cardiac transplant patient. Semin Perinatol 2014; 38: 318325.Google Scholar
8. Wasywich, CA, Ruygrok, PN, Wilkinson, L, Gibbs, H, Coverdale, HA. Planned pregnancy in a heart transplant recipient. Intern Med J 2004; 34: 206209.Google Scholar
9. Hoedemaekers, YM, Caliskan, K, Michels, M, et al. The importance of genetic counseling, DNA diagnostics, and cardiologic family screening in left ventricular noncompaction cardiomyopathy. Circ Cardiovasc Genet 2010; 3: 232239.Google Scholar
10. Landrum, MJ, Lee, JM, Benson, M, et al. ClinVar: public archive of interpretations of clinically relevant variants. Nucleic Acids Res 2016; 44: D862D868.Google Scholar
11. George, CH, Higgs, GV, Lai, FA. Ryanodine receptor mutations associated with stress-induced ventricular tachycardia mediate increased calcium release in stimulated cardiomyocytes. Circ Res 2003; 93: 531540.Google Scholar
12. Tester, DJ, Will, ML, Haglund, CM, Ackerman, MJ. Compendium of cardiac channel mutations in 541 consecutive unrelated patients referred for long QT syndrome genetic testing. Heart Rhythm 2005; 2: 507517.Google Scholar
13. Towbin, JA, Lowe, AM, Colan, SD, et al. Incidence, causes, and outcomes of dilated cardiomyopathy in children. JAMA 2006; 296: 18671876.Google Scholar