Associated clinical and laboratory markers of donor on allograft function after heart transplant
Rev. bras. cir. cardiovasc
; 31(2): 89-97, Mar.-Apr. 2016. tab, graf
Article
in English
| LILACS
| ID: lil-792643
Responsible library:
BR1.1
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.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
Database:
LILACS
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
/
CIRURGIA GERAL
Year:
2016
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Federal University of Minas Gerais/BR