Impact of Elevated Donor Troponin I as Predictor of Adverse Outcome in Adult Heart Transplantation: A Single-center Experience

Abstract

Elevated donor TnI serum concentration seems to be a marker for adverse outcome and increased short- and long-term mortality after HTx. Nevertheless, many other perioperative variables and parameters can be associated with outcome.

Donor Cardiac Troponin for Prognosis of Adverse Outcomes in Cardiac Transplantation Recipients: a Systematic Review and Meta-analysis

“…Freundt et al 38 reported a nonsignificant OR of 1.30 (95% CI, 0.11-14.65) for elevated donor troponin and graft rejection within 30 d.…”

Suppression of tumorigenicity‐2 (ST2) is a promising biomarker in heart transplantation

“…A large series demonstrated that elevated donor's nonhigh sensitivity troponin I serum levels in the setting of preserved LVEF were not associated with primary graft failure, CAV or short and midterm mortality after HT 16 . Conversely, a report on a smaller cohort from a single‐center experience showed that elevated donor's nonhigh sensitivity troponin I serum concentration may be a marker for adverse outcome and increased short‐ and long‐term mortality after HT 17 . Previous reports showed that natriuretic peptides levels were higher in donors whose hearts were declined for transplantation compared with donors whose hearts were considered acceptable for transplantation 18,19 .…”

“…16 Conversely, a report on a smaller cohort from a single-center experience showed that elevated donor's nonhigh sensitivity troponin I serum concentration may be a marker for adverse outcome and increased short-and longterm mortality after HT. 17 Previous reports showed that natriuretic peptides levels were higher in donors whose hearts were declined for transplantation compared with donors whose hearts were considered Recipient M12 28 23 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] .4…”

Noteworthy Literature Published in 2017 for Thoracic Transplantation Anesthesiologists

“…Freundt et al, 80 Lazzeri et al, 81 Chen et al, 82 Madan et al 83 Donor reduced LVEF does not negatively impact recipient outcomes and mortality.…”

“…Donor hypertension 77 has been shown to affect survival, and prolonged QTc interval >500 milliseconds 78 have been shown accelerate the development of CAV. Hyperglycemia, 79 reduced LV function, 80 -83 and longer distance between donor and recipient hospital 84 have been studied recently and have not been shown to affect outcomes.…”