title: Donor Troponin and Survival After Cardiac Transplantation: An Analysis of the United Network of Organ Sharing Registry.
abstract: Despite a limited supply of organs, only 1 in 3 potential donor hearts is accepted for transplantation. Elevated donor troponin levels have generally been considered a contraindication to heart transplantation; however, the data supporting this practice are limited.
  
  
  
  We identified 10 943 adult (≥18 years) heart transplant recipients in the United Network of Organ Sharing (UNOS) database with preserved donor left ventricular ejection fraction (≥50%) and where peak donor troponin I values were available. When analyzed as a continuous variable, there was no association between peak donor troponin levels and recipient mortality up to 1 year follow-up in unadjusted (hazards ratio, 0.999; 95% confidence interval, 0.997-1.002; P=0.856) and adjusted Cox models (hazards ratio, 1.000; 95% confidence interval, 0.997-1.002; P=0.950). Next, we divided the entire cohort into 3 groups based on donor troponin I values: <1 ng/mL (n=7812), 1 to 10 ng/mL (n=2770), and >10 ng/mL (n=361). Using unadjusted and adjusted Cox models and Kaplan-Meier analysis, there was no significant difference in recipient mortality at 30 days, 1 year, 3 years, or 5 years between the 3 groups. Similarly, cardiac allograft vasculopathy up to 5 years and primary graft failure up to 30 days of follow-up post transplant did not differ between the 3 donor troponin groups. The median length of hospital stay post transplant was also similar across groups.
  
  
  
  Elevated donor troponin I levels in the setting of preserved left ventricular ejection fraction were not associated with intermediate-term mortality, cardiac allograft vasculopathy, or primary graft failure rates in hearts accepted for transplantation. This finding could help expand the donor pool.
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Shivank
authors.initials: S
authors.lastname: Madan
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Omar
authors.initials: O
authors.lastname: Saeed
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Jooyoung
authors.initials: J
authors.lastname: Shin
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sims
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Daniel
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Ileana
authors.initials: I
authors.lastname: Piña
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jorde
authors.affiliation: From the Division of Cardiology, Department of Medicine (S.M., O.S., J.S., D.S., I.P., U.J., S.R.P.) and Department of Cardiovascular and Thoracic Surgery (D.G.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY. snepatel@montefiore.org.
authors.forename: Snehal R
authors.initials: SR
authors.lastname: Patel
mesh_terms: D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D014481:United States; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D019210:Troponin I
keywords: allograft; graft failure; mortality; transplantation; troponin