Procalcitonin, a donor-specific predictor of early graft failure-related mortality after heart transplantation

Area of Science:

• Cardiology
• Transplantation Immunology
• Biomarker Discovery

Background:

• Donor-specific markers for predicting heart transplant outcomes are currently unknown.
• Procalcitonin (PCT) is associated with inflammation and organ perfusion but its role in heart donors is unstudied.
• This study investigates PCT as a potential predictor of early graft failure after heart transplantation (HTx).

Purpose of the Study:

• To evaluate procalcitonin (PCT) as a predictor of early graft failure-related mortality after heart transplantation (HTx).

Main Methods:

• Serum concentrations of PCT and C-reactive protein (CRP) were measured in 81 brain-dead multi-organ heart donors.
• Donors were retrospectively divided into groups based on recipient 30-day mortality post-HTx.
• Receiver operating characteristic (ROC) curves were used to assess predictive performance.

Main Results:

• PCT demonstrated a higher area under the ROC curve (0.71) compared to CRP (0.64) for predicting graft failure-related mortality.
• A PCT level >2 ng/mL predicted graft failure-related mortality with 95.8% specificity and 50.0% sensitivity.
• Donors with PCT >2 ng/mL had a significantly increased odds ratio for graft failure-related mortality (adjusted OR 43.8).

Conclusions:

• A procalcitonin (PCT) level exceeding 2 ng/mL in cardiac donors at explantation is a potential predictor of early graft failure-related mortality.
• This finding may aid in donor selection and improve outcomes for heart transplant recipients.