Elevated donor cardiac troponin T and procalcitonin indicate two independent mechanisms of early graft failure after heart transplantation.
BACKGROUND
Cardiac troponin T (cTnT) >0.1 microg/l and procalcitonin (PCT) >2 microg/l in the serum of heart donors are predictors of early graft failure after heart transplantation (HTx). The current study investigates the relationship between these two markers and their prognostic value when one or both of them are elevated.


METHODS
Cardiac TnT and PCT were measured in serum from 92 consecutive brain-dead donors accepted for HTx. The donors were retrospectively divided into two groups: group I (n=78) donors of hearts with good function, group II (n=14) donors of hearts with early graft failure after transplantation.


RESULTS
There were no correlations between cTnT and PCT values (r=0.12, P=0.27). In eight donors in group I one or both markers were elevated. In one donor both markers were above the cut-off levels. In 12 donors (86%) in group II one or both markers were elevated. In two donors both markers were above the cut-off levels and in a further two below. There was no significant interaction between the two markers in either group using a logistic regression model (P=0.28).


CONCLUSIONS
Elevated cTnT and PCT levels in the serum of heart donors were independent prognostic markers of early graft failure. This fact may suggest two different mechanisms of early graft failure: primary myocardial damage and damage related to systemic inflammatory response. The combination of both markers had a higher sensitivity than each parameter on its own. Their use as additional parameters may improve heart donor selection.
Potapov
Evgenij V
EV
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. potapov@dhzb.de
Wagner
Frank D
FD
Loebe
Matthias
M
Ivanitskaia
Ekaterina A
EA
Müller
Christian
C
Sodian
Ralf
R
Jonitz
Britta
B
Hetzer
Roland
R
D000328:Adult; D001926:Brain Death; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016022:Case-Control Studies; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006085:Graft Survival; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood; D013997:Time Factors; D014019:Tissue Donors; D020107:Troponin T / Q000097:blood*
C000606589:CALCA protein, human; D006023:Glycoproteins; D011498:Protein Precursors; D020107:Troponin T; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide