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Title
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Biomarkers and donor selection in heart transplantation
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Author
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Abstract
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| Background. Previously, we showed that B-type natriuretic peptide (BNP) measured in the donor was related to cardiac performance after cardiac transplantation. The present study assesses the value of 3 biomarkers in the selection of donor hearts in a larger cohort. Methods. Blood samples were prospectively obtained in 105 brain-dead patients scheduled for heart donation. BNP, soluble suppressor of tumorigenicity 2 (ST2), and troponin of heart donors were correlated with hemodynamic parameters early after transplantation as well as with the mortality of the recipients. Results. A significant inverse relationship was found between donor BNP measured at the time of donation and recipient cardiac index and cardiac output at day 13 post transplantation (r = -0.31, P = .005, and r = 0.34, P = .0016, respectively). Logistic regression analysis including BNP, ST2, and troponin showed that donor BNP was a predictor of a poor cardiac index (< 2.2 L/min/m(2)) in the recipient (P = .04). A donor BNP > 132 pg/mL has a sensitivity of 56% (95% confidence interval 21-86) and a specificity of 86% (95% confidence interval 77-93) to predict poor cardiac performance in the recipient. When the donor BNP is < 132 pg/mL, the risk of a poor cardiac function in the recipient is very low (negative predictive value 94%). Mortality at 30 days was also correlated to donor BNP (r = 0.29, P = .0029). Long-term survival of the recipient was not correlated to the biomarkers measured in the donor. Conclusion. Donor BNP, but not donor ST2 or high-sensitivity troponin, provides information on the donor heart and early post-transplant performance, including 1-month mortality. |
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Language
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English
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Source (journal)
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Transplantation proceedings. - New York, N.Y.
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Publication
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New York, N.Y.
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2019
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ISSN
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0041-1345
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DOI
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10.1016/J.TRANSPROCEED.2019.04.041
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Volume/pages
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51
:6
(2019)
, p. 1673-1678
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ISI
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000482696500007
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Pubmed ID
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31307770
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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