title: Troponin I levels from donors accepted for pediatric heart transplantation do not predict recipient graft survival.
abstract: BACKGROUND
  Troponin I is often obtained during the evaluation of a potential transplant donor heart. It is not clear whether elevations in donor troponin I levels predict adverse outcomes and should thus preclude acceptance of a donor heart. This study examined whether troponin I levels from donors accepted for pediatric heart transplantation predicted graft failure.
  
  
  METHODS
  Deidentified data on heart transplants performed in recipients aged < 21 years between April 2007 and April 2009 was provided by the Organ Procurement and Transplantation Network. Donor troponin I level and recipient outcomes, including survival without retransplantation (graft survival), were examined for statistical correlation.
  
  
  RESULTS
  Overall graft survival in 839 heart transplants was 81% at 2 years. At least 1 troponin I level was recorded in 657 donors before transplant, with a median value of 0.1 ng/ml (range, 0-50 ng/ml). Troponin I level and graft status were not correlated (p = 0.74). A receiver operating characteristic curve showed no association between troponin I and graft status (area under the curve, 0.51; p = 0.98). Graft survival did not differ significantly (p = 0.60) among quartiles of troponin I levels (<0.04, 0.04-<0.1, 0.1-<0.35, ≥ 0.35 ng/ml). A troponin I level ≥ 1 ng/ml was found in 74 transplanted donor hearts; graft survival was not associated with troponin I ≥ 1 (80%) vs < 1 (80%) at 2 years (p = 0.93). Troponin I values were not associated with post-transplant hospital length of stay (r = -0.06; p = 0.10).
  
  
  CONCLUSIONS
  In donor hearts accepted for pediatric heart transplantation, troponin I elevation before procurement is not associated with increased graft failure. The significance of elevated troponin I levels, which occurs in many heart donors, remains unclear and should therefore be considered in the context of other clinical information.
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. linky@email.chop.edu
authors.forename: Kimberly Y
authors.initials: KY
authors.lastname: Lin
authors.forename: Patrick
authors.initials: P
authors.lastname: Sullivan
authors.forename: Abdul
authors.initials: A
authors.lastname: Salam
authors.forename: Beth
authors.initials: B
authors.lastname: Kaufman
authors.forename: Stephen
authors.initials: S
authors.lastname: Paridon
authors.forename: Brian D
authors.initials: BD
authors.lastname: Hanna
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Spray
authors.forename: Janice
authors.initials: J
authors.lastname: Weber
authors.forename: Robert
authors.initials: R
authors.lastname: Shaddy
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006085:Graft Survival; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis; D016027:Heart Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D014180:Transplantation; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019210:Troponin I