title: Plasma B-type natriuretic peptide levels in cardiac donors.
abstract: BACKGROUND
  Elevated levels of plasma brain natriuretic peptide (BNP) and amino-terminal BNP (NT-proBNP) are associated with adverse cardiac outcomes. It is not known whether BNP and NT-proBNP levels in heart donors can aid in selection and predict outcomes in transplant recipients.
  
  
  METHODS
  Plasma BNP and NT-proBNP were measured in 32 organ donors prior to removal from life-support systems. Twelve hearts were accepted and 20 hearts were declined (no suitable recipient - 12, probable coronary artery disease - four, abnormal echocardiogram - three, other medical reasons - one). Records of heart transplant recipients were reviewed for: survival at 30 d, length of intensive care stay and need for intra-aortic balloon counter-pulsation (IABP).
  
  
  RESULTS
  Donors were divided into three groups - Group 1 (n = 12): accepted hearts; Group 2 (n = 12): acceptable hearts not transplanted for logistic reasons; Group 3 (n = 8): declined because of probable cardiac disease. BNP and NT-proBNP levels were significantly lower in donors with acceptable hearts (n = 24) compared with those with unacceptable hearts (n = 8) (p = 0.02 and 0.032, respectively). Of the 12 patients transplanted, four suffered a suboptimal outcome (two died, one required inotropic support and IABP, one prolonged hospitalization) while eight had good outcomes with no significant difference in BNP/NT-proBNP levels between these groups.
  
  
  CONCLUSIONS
  BNP and NT-proBNP levels were lower in organ donors whose hearts were acceptable for transplantation compared with those whose hearts were unsuitable. Measuring natriuretic peptides may be a useful adjunctive tool in the selection of donor hearts. We feel that further studies are warranted.
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Nezar L
authors.initials: NL
authors.lastname: Amir
authors.forename: Ivor L
authors.initials: IL
authors.lastname: Gerber
authors.forename: John J
authors.initials: JJ
authors.lastname: Edmond
authors.forename: Janice M
authors.initials: JM
authors.lastname: Langlands
authors.forename: A Mark
authors.initials: AM
authors.lastname: Richards
authors.forename: Peter N
authors.initials: PN
authors.lastname: Ruygrok
mesh_terms: D000328:Adult; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain