Long-Term Survival Following Heart Transplantation in a Patient With Dilated Cardiomyopathy and Papillary Thyroid Carcinoma

Abstract

This case report details the remarkable long-term survival of a 73-year-old female who underwent bicaval heart transplantation 13 years ago due to severe heart failure caused by dilated cardiomyopathy (DCM) with an ejection fraction of 10. Simultaneously, she was diagnosed with papillary thyroid carcinoma (PTC). Despite the potential complications, her case highlights the feasibility of heart transplantation in patients with concurrent, non-aggressive cancers. Post-transplant, she underwent successful total thyroidectomy and cervical lymph node dissection three months after heart transplantation to address her PTC. Over the 13 years following the transplantation, she maintained stable cardiac health, evidenced by consistent left ventricular ejection fraction improvements, peaking at 55. However, she developed severe osteoporosis and experienced vertebral fractures due to significant hypocalcemia in the setting of hyperparathyroidism, which was managed with vertebroplasty. This case underscores the importance of a multidisciplinary approach in managing complex cases involving both severe cardiac and oncological conditions and emphasizes the potential for positive outcomes with comprehensive medical and surgical interventions. © 2026 Tehran University of Medical Sciences. All rights reserved.