Abstract
Background Due to globally increasing donor organ shortage, investigation of previously described
risk factors for utilizing marginal donor hearts is needed. The aim of this study
was to determine the impact of elevated donor serum troponin I (TnI) levels on outcome
after heart transplantation (HTx).
Methods Between January 1996 and August 2013, 161 patients were reviewed for donor TnI serum
levels (>0.3 ng/mL was considered elevated), postoperative outcome parameters, 30-day
mortality, and 1-, 3-, and 5-year survival.
Results TnI levels were elevated in 45 (28.0%) donors. Recipients of hearts with elevated
TnI had higher incidence of postoperative systolic dysfunction, prolonged inotropic
support, prolonged mechanical ventilation, and longer intensive care unit (ICU) stay
(p < 0.001). This group had higher 30-day mortality (22.2% vs 8.6%, p = 0.03) and lower 1-, 3-, and 5-year survival (56%, 53%, and 50% versus 82%, 76%,
and 69%, p = 0.032). Elevated TnI was the only independent risk factor for 30-day mortality
(odds ratio [OR] 3.63, 95% confidence interval [CI] 1.28–10.27, p = 0.015).
Conclusions Elevated donor TnI serum concentration seems to be a marker for adverse outcome and
increased short- and long-term mortality after HTx. Nevertheless, many other perioperative
variables and parameters can be associated with outcome.
Keywords
heart transplantation - organ donor selection - transplant outcome - troponin I
