Donor Cardiac Troponin-T Predicts Subsequent Inotrope Requirements Following Cardiac Transplantation

Anderson, Jon R.; Hossein-Nia, M; Brown, Parker; Holt, D W; Murday, A. J.

doi:10.1097/00007890-199411150-00016

Cited by 25 publications

(20 citation statements)

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“…Among these are cardiac troponins, markers of myocardial injury or infarction and an important prognostic index in ischaemic heart disease and advanced heart failure [5]. Elevated troponins have been correlated with donor heart dysfunction and may predict adverse recipient outcome, being associated in some studies with increased risk of early graft failure and increased rates of inotrope requirement post-transplantation and post-transplant rejection [6][7][8][9][10] However, this association remains controversial as equivalent outcomes have been achieved in other studies with no increased risk of rejection [11][12][13]. The objectives of this study were to evaluate the prevalence of cardiac troponin-I (cTnI) elevation in heart donors, its relationship to donor heart function and time from coning, its predictive value of donor heart suitability and posttransplant recipient outcome in a prospective study.…”

Section: Introductionmentioning

confidence: 99%

Donor cardiac troponin-I: a biochemical surrogate of heart function☆☆☆

Venkateswaran¹,

Ganesh²,

Thekkudan³

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Section: Introductionmentioning

confidence: 99%

Donor cardiac troponin-I: a biochemical surrogate of heart function☆☆☆

Venkateswaran¹,

Ganesh²,

Thekkudan³

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…For these reasons, the value of donor cardiac troponin in organ selection has been an ongoing area of investigation. In a pivotal study, Potapov et al 6 found that donor troponin levels were 21 higher rates of rejection, 8 higher rates of graft failure, and death in infants. 7 In contrast, a more recent analysis from the California Transplant Donor Network, found no difference in 1-year survival between the 43 recipients of an organ with elevated serum troponin compared with the 96 patients with normal troponin levels.…”

Section: Discussionmentioning

confidence: 99%

Donor Troponin and Survival After Cardiac Transplantation

Madan

Saeed

Shin

et al. 2016

Circ: Heart Failure

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Background-Despite a limited supply of organs, only 1 in 3 potential donor hearts is accepted for transplantation. Elevated donor troponin levels have generally been considered a contraindication to heart transplantation; however, the data supporting this practice are limited. Methods and Results-We identified 10 943 adult (≥18 years) heart transplant recipients in the United Network of Organ Sharing (UNOS) database with preserved donor left ventricular ejection fraction (≥50%) and where peak donor troponin I values were available. When analyzed as a continuous variable, there was no association between peak donor troponin levels and recipient mortality up to 1 year follow-up in unadjusted (hazards ratio, 0.999; 95% confidence interval, 0.997-1.002; P=0.856) and adjusted Cox models (hazards ratio, 1.000; 95% confidence interval, 0.997-1.002; P=0.950). Next, we divided the entire cohort into 3 groups based on donor troponin I values: <1 ng/mL (n=7812), 1 to 10 ng/mL (n=2770), and >10 ng/mL (n=361). Using unadjusted and adjusted Cox models and Kaplan-Meier analysis, there was no significant difference in recipient mortality at 30 days, 1 year, 3 years, or 5 years between the 3 groups. Similarly, cardiac allograft vasculopathy up to 5 years and primary graft failure up to 30 days of follow-up post transplant did not differ between the 3 donor troponin groups. The median length of hospital stay post transplant was also similar across groups. Conclusions-Elevated donor troponin I levels in the setting of preserved left ventricular ejection fraction were not associated with intermediate-term mortality, cardiac allograft vasculopathy, or primary graft failure rates in hearts accepted for transplantation. This finding could help expand the donor pool. (Circ Heart Fail. 2016;9:e002909.

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“…Moreover, the small sample size did not allow adjustment for known risk factors for PGD, including donor age and ischaemic time and a number of other recipient characteristics [24]. Nevertheless, larger studies may identify individual biomarkers as risk factors for PGD as has been partly shown for troponins [25], procalcitonin [19] and tumour necrosis factor-a [21].…”

Section: Discussionmentioning

confidence: 99%