Troponin T and I are not reliable markers of cardiac transplant rejection.
OBJECTIVE
Heart transplant recipients undergo a number of invasive endomyocardial biopsies to screen for rejection. Serum assays of troponin T and/or I may provide a less invasive alternative. The purpose of this study was to evaluate troponin T and I as markers of cardiac transplant rejection.


METHODS
We conducted a prospective analysis comparing troponin T and I levels to biopsy results in heart transplant recipients. Plasma was assayed for troponin T and I preoperatively, on the first 3 postoperative days, and with each subsequent biopsy.


RESULTS
Twenty-nine patients entered the study. A total of 173 biopsies were performed at a mean follow-up of 129+/-9 days (range: 12-564 days). There were two rejection episodes (> or = grade 3), one in each of two patients. There were no significant relationships between troponin T or I and biopsy-proven rejection (> or = grade 3; P=0.59 and 0.54, respectively). There were also no correlations between troponin T or I levels and biopsy grade (P=0.40 and 0.92, respectively). Troponin T and I levels peaked on postoperative day 1 and fell to baseline over long-term follow-up with no peak in serum markers associated with rejection episodes. Donor ischemic time was significantly correlated to troponin T on postoperative days 1-3 (r=0.58, P=0.005; r=0.61, P=0.004; and r=0.61, P=0.003, respectively).


CONCLUSIONS
Troponin T and I are not useful indicators of cardiac rejection, but do correlate with donor heart ischemic injury.
Mullen
J C
JC
Division of Cardiac Surgery, The University of Alberta Hospital, 2D2.18 W.C. Mackenzie Health Sciences Centre, 8440-112 Street, Edmonton, Alta T6G 2B7, Canada. jmullen@ualberta.ca
Bentley
M J
MJ
Scherr
K D
KD
Chorney
S G
SG
Burton
N I
NI
Tymchak
W J
WJ
Koshal
A
A
Modry
D L
DL
D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T