Serum troponin Ic values in organ donors are related to donor myocardial dysfunction but not to graft dysfunction or rejection in the recipients

被引:23
作者
Boccheciampe, N. [1 ,2 ]
Audibert, G. [1 ,2 ]
Rangeard, O. [1 ,2 ]
Charpentier, C. [1 ,2 ]
Perrier, J. F. [1 ,2 ]
Lalot, J. M. [1 ,2 ]
Voltz, C. [1 ,2 ]
Strub, P. [1 ,2 ]
Loos-Ayav, Carole [1 ,2 ,4 ]
Meistelman, C. [1 ,2 ]
Mertes, P. M. [1 ,2 ,3 ]
Longrois, D. [1 ,2 ,3 ]
机构
[1] Ctr Hosp Univ Nancy, Dept Anesthesia, Nancy, France
[2] Ctr Hosp Univ Nancy, Dept Intens Care, Nancy, France
[3] Univ Henri Poincare, Fac Med, INSERM, U684, Nancy, France
[4] Ctr Hosp Univ Nancy Hop Marin, CEC, INSERM, Assistante Hosp Univ Serv Epidemiol & Evaluat Cli, Nancy, France
关键词
Brain death; Organ donor; Troponin Ic; Transplantation; FAILURE; TRANSPLANTATION; LIMITATIONS; SELECTION; MARKER;
D O I
10.1016/j.ijcard.2007.12.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Increased plasma cardiac troponin I (cTnI) values in heart donors are associated with donor myocardial dysfunction and increased risk of rejection in the recipients. We investigated the association between cTnI values and myocardial dysfunction in potential heart donors and the relationship between donors' cTnI values and recipients' early myocardial function and 1 year survival and risk of rejection. Methods: cTnI was measured in 159 consecutive potential heart donors. Myocardial function was estimated by the left ventricular ejection fraction (LVEF) and segmental wall motion abnormalities (SWMA). Results are mean +/- SD (range) or median (interquartile range). Results: cTnI values in potential donors were 2.1 +/- 5 ng/ml (0-40.4 ng/ml); cTnI values were significantly (P<0.001) higher: 4.2 +/- 5.9 ng/ml (0-30.6 ng/ml) for potential donors with LVEF <50% versus LVEF >50%: 1.7 +/- 4.7 ng/ml (0-40.4 ng/ml). cTnI values were significantly lower for donors without SWMA. cTnI values were significantly (P<0.001) lower for the 90 donors whose hearts were harvested: 1.1 +/- 2.3 ng/ml(0-15.6 ng/ml) versus the not harvested: 3.6 +/- 6.9 ng/ml (0-40.4 ng/ml). There were 87 recipients followed for 1 year. Donors' cTnI values were not associated with early alteration of LVEF, incidence of rejection or 1 year recipients' survival. Conclusion: Increased cTnI values in potential heart donors are statistically associated with myocardial dysfunction and could be helpful for organ selection. In contrast, cTnI values in heart donors were not associated with graft dysfunction or recipient survival after transplantation. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:80 / 86
页数:7
相关论文
共 18 条
[1]   DONOR CARDIAC TROPONIN-T PREDICTS SUBSEQUENT INOTROPE REQUIREMENTS FOLLOWING CARDIAC TRANSPLANTATION [J].
ANDERSON, JR ;
HOSSEINNIA, M ;
BROWN, P ;
HOLT, DW ;
MURDAY, A .
TRANSPLANTATION, 1994, 58 (09) :1056-1057
[2]   SELECTION AND TREATMENT OF CANDIDATES FOR HEART-TRANSPLANTATION - A STATEMENT FOR HEALTH-PROFESSIONALS FROM THE COMMITTEE ON HEART-FAILURE AND CARDIAC TRANSPLANTATION OF THE COUNCIL ON CLINICAL CARDIOLOGY, AMERICAN-HEART-ASSOCIATION [J].
COSTANZO, MR ;
AUGUSTINE, S ;
BOURGE, R ;
BRISTOW, M ;
OCONNELL, JB ;
DRISCOLL, D ;
ROSE, E .
CIRCULATION, 1995, 92 (12) :3593-3612
[3]   ELEVATED DONOR CARDIAC TROPONIN-I - A MARKER OF ACUTE GRAFT FAILURE IN INFANT HEART RECIPIENTS [J].
GRANT, JW ;
CANTER, CE ;
SPRAY, TL ;
LANDT, Y ;
SAFFITZ, JE ;
LADENSON, JH ;
JAFFE, AS .
CIRCULATION, 1994, 90 (06) :2618-2621
[4]   Current trends in heart transplantation [J].
Massad, MG .
CARDIOLOGY, 2004, 101 (1-3) :79-92
[5]   Elevated donor troponin levels are associated with a lower frequency of allograft vasculopathy [J].
Miller, WL ;
Edwards, BS ;
Kremers, WK ;
Kushwaha, SS ;
McGregor, CGA ;
Daly, RC ;
Jaffe, AS .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2005, 24 (12) :2075-2078
[6]   Mitigation at che clinical significance of spurious elevations of cardiac troponin I in settings of coronary ischemia using serial testing of multiple cardiac markers [J].
Ng, SM ;
Krishnaswamy, P ;
Morrisey, R ;
Clopton, P ;
Fitzgerald, R ;
Maisel, AS .
AMERICAN JOURNAL OF CARDIOLOGY, 2001, 87 (08) :994-999
[7]   Limitations of the odds ratio in gauging the performance of a diagnostic, prognostic, or screening marker [J].
Pepe, MS ;
Janes, H ;
Longton, G ;
Leisenring, W ;
Newcomb, P .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2004, 159 (09) :882-890
[8]   Elevated donor cardiac troponin T and procalcitonin indicate two independent mechanisms of early graft failure after heart transplantation [J].
Potapov, EV ;
Wagner, FD ;
Loebe, M ;
Ivanitskaia, EA ;
Müller, C ;
Sodian, R ;
Jonitz, B ;
Hetzer, R .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2003, 92 (2-3) :163-167
[9]   Value of cardiac troponin I and T for selection of heart donors and as predictors of early graft failure [J].
Potapov, EV ;
Ivanitskaia, EA ;
Loebe, M ;
Möckel, M ;
Müller, C ;
Sodian, R ;
Meyer, R ;
Hetzer, R .
TRANSPLANTATION, 2001, 71 (10) :1394-1400
[10]   CIRCULATING CARDIAC TROPONIN-T IN POTENTIAL HEART-TRANSPLANT DONORS [J].
RIOU, B ;
DREUX, S ;
ROCHE, S ;
ARTHAUD, M ;
GOARIN, JP ;
LEGER, P ;
SAADA, M ;
VIARS, P .
CIRCULATION, 1995, 92 (03) :409-414