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
em En
| LILACS
| ID: lil-792643
Biblioteca responsável:
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.Palavras-chave
Texto completo:
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Índice:
LILACS
Assunto principal:
Doadores de Tecidos
/
Norepinefrina
/
Transplante de Coração
/
Disfunção Primária do Enxerto
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
CARDIOLOGIA
/
CIRURGIA GERAL
Ano de publicação:
2016
Tipo de documento:
Article