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Associated clinical and laboratory markers of donor on allograft function after heart transplant
Braulio, Renato; Sanches, Marcelo Dias; Teixeira Junior, Antonio Lúcio; Costa, Paulo Henrique Nogueira; Moreira, Maria da Consolação Vieira; Rocha, Monaliza Angela; Andrade, Silvio Amadeu de; Gelape, Cláudio Léo.
  • Braulio, Renato; Federal University of Minas Gerais. Belo Horizonte. BR
  • Sanches, Marcelo Dias; Federal University of Minas Gerais. Belo Horizonte. BR
  • Teixeira Junior, Antonio Lúcio; Federal University of Minas Gerais. Belo Horizonte. BR
  • Costa, Paulo Henrique Nogueira; Federal University of Minas Gerais. Belo Horizonte. BR
  • Moreira, Maria da Consolação Vieira; Federal University of Minas Gerais. Belo Horizonte. BR
  • Rocha, Monaliza Angela; Federal University of Minas Gerais. Belo Horizonte. BR
  • Andrade, Silvio Amadeu de; Federal University of Minas Gerais. Belo Horizonte. BR
  • Gelape, Cláudio Léo; Federal University of Minas Gerais. Belo Horizonte. BR
Rev. bras. cir. cardiovasc ; 31(2): 89-97, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-792643
ABSTRACT
Abstract

Introduction:

Primary graft dysfunction is a major cause of mortality after heart transplantation.

Objective:

To evaluate correlations between donor-related clinical/biochemical markers and the occurrence of primary graft dysfunction/clinical outcomes of recipients within 30 days of transplant.

Methods:

The prospective study involved 43 donor/recipient pairs. Data collected from donors included demographic and echocardiographic information, noradrenaline administration rates and concentrations of soluble tumor necrosis factor receptors (sTNFR1 and sTNFR2), interleukins (IL-6 and IL-10), monocyte chemoattractant protein-1, C-reactive protein and cardiac troponin I. Data collected from recipients included operating, cardiopulmonary bypass, intensive care unit and hospitalization times, inotrope administration and left/right ventricular function through echocardiography.

Results:

Recipients who developed moderate/severe left ventricular dysfunction had received organs from significantly older donors (P =0.020). Recipients from donors who required moderate/high doses of noradrenaline (>0.23 µg/kg/min) around harvesting time exhibited lower post-transplant ventricular ejection fractions (P =0.002) and required longer CPB times (P =0.039). Significantly higher concentrations of sTNFR1 (P =0.014) and sTNFR2 (P =0.030) in donors were associated with reduced intensive care unit times (≤5 days) in recipients, while higher donor IL-6 (P =0.029) and IL-10 (P =0.037) levels were correlated with reduced hospitalization times (≤25 days) in recipients. Recipients who required moderate/high levels of noradrenaline for weaning off cardiopulmonary bypass were associated with lower donor concentrations of sTNFR2 (P =0.028) and IL-6 (P =0.001).

Conclusion:

High levels of sTNFR1, sTNFR2, IL-6 and IL-10 in donors were associated with enhanced evolution in recipients. Allografts from older donors, or from those treated with noradrenaline doses >0.23 µg/kg/min, were more frequently affected by primary graft dysfunction within 30 days of surgery.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Tissue Donors / Norepinephrine / Heart Transplantation / Primary Graft Dysfunction Type of study: Etiology study / Observational study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2016 Type: Article Affiliation country: Brazil Institution/Affiliation country: Federal University of Minas Gerais/BR

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Full text: Available Index: LILACS (Americas) Main subject: Tissue Donors / Norepinephrine / Heart Transplantation / Primary Graft Dysfunction Type of study: Etiology study / Observational study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2016 Type: Article Affiliation country: Brazil Institution/Affiliation country: Federal University of Minas Gerais/BR