Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
J Heart Lung Transplant. 2011 Aug;30(8):920-7. doi: 10.1016/j.healun.2011.02.011. Epub 2011 Apr 13.
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.
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.
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).
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.
肌钙蛋白 I 常用于评估潜在的移植供体心脏。目前尚不清楚供体肌钙蛋白 I 水平升高是否预示着不良结局，因此是否应排除接受供体心脏。本研究旨在探讨接受小儿心脏移植的供体肌钙蛋白 I 水平是否预测移植物衰竭。
本研究由器官获取与移植网络提供了 2007 年 4 月至 2009 年 4 月期间接受年龄<21 岁的心脏移植患者的匿名数据。检查供体肌钙蛋白 I 水平与受体结局（包括无再次移植的存活率[移植物存活率]）之间的统计学相关性。
839 例心脏移植患者的总体 2 年移植物存活率为 81%。在移植前，至少有 1 例供体的肌钙蛋白 I 水平被记录，中位数为 0.1ng/ml（范围：0-50ng/ml）。肌钙蛋白 I 水平与移植物状态无相关性（p=0.74）。受试者工作特征曲线显示肌钙蛋白 I 与移植物状态之间无关联（曲线下面积为 0.51，p=0.98）。在肌钙蛋白 I 水平的四分位数（<0.04，0.04-<0.1，0.1-<0.35，≥0.35ng/ml）中，移植物存活率无显著差异（p=0.60）。在 74 例接受移植的供体心脏中发现肌钙蛋白 I 水平≥1ng/ml；2 年时，移植物存活率与肌钙蛋白 I≥1（80%）与<1（80%）之间无相关性（p=0.93）。肌钙蛋白 I 值与移植后住院时间的长短无关（r=-0.06，p=0.10）。
在接受小儿心脏移植的供体心脏中，采集前肌钙蛋白 I 升高与移植物衰竭无关。许多心脏供体中出现的升高的肌钙蛋白 I 水平的意义尚不清楚，因此应结合其他临床信息进行考虑。
