title: Pretransplant serum troponin levels are highly predictive of patient and graft survival following liver transplantation.
abstract: Optimizing the utility of liver transplantation requires the identification of factors that confer increased risk of posttransplant mortality. Elevated serum troponin (TN) levels are strongly predictive of posttransplant mortality after kidney transplantation. We sought to determine whether pretransplant TN levels were predictive of mortality and graft loss after liver transplantation in 236 liver transplant recipients from 1998 to 2001 with 8.2 years of follow-up. Elevated TN levels [hazard ratio (HR) = 2.19, P = 0.004] and a pretransplant history of cardiovascular disease (CVD; HR = 1.90, P = 0.031) were predictive of patient mortality. Elevated TN levels (HR = 2.44, P < 0.001), a history of CVD (HR = 1.83, P = 0.031), and a combination of elevated TN levels and CVD (HR = 2.75, P = 0.027) were associated with increased graft loss. Multivariate analysis confirmed TN and CVD as independent predictors of mortality and graft loss. CVD (HR = 2.39, P = 0.032) and a combination of elevated TN levels and a history of CVD (HR = 6.67, P < 0.001) were predictive of graft loss within 1 year. Age, smoking, diabetes, hypertension, obesity, creatinine levels, and Model for End-Stage Liver Disease scores were not predictive of posttransplant mortality or graft loss. In summary, elevated pretransplant serum TN levels are strongly predictive of mortality and graft loss after liver transplantation and may be helpful in risk stratification of potential liver transplant recipients.
authors.affiliation: Mayo Clinic Transplant Center, Rochester, MN 55905, USA.
authors.forename: Kymberly D S
authors.initials: KD
authors.lastname: Watt
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Coss
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Pedersen
authors.forename: Ross
authors.initials: R
authors.lastname: Dierkhising
authors.forename: Julie K
authors.initials: JK
authors.lastname: Heimbach
authors.forename: Michael R
authors.initials: MR
authors.lastname: Charlton
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D017093:Liver Failure / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood*
chemical_list: D014336:Troponin