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Assessment of the potential heart donor: a role for biomarkers?
Vamsidhar B Dronavalli1, Nicholas R Banner, Robert S Bonser
1Department of Cardiothoracic Surgery, Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham B15 2TH, United Kingdom.
Insights
Biomarkers could improve donor heart selection, addressing the critical shortage and preventing early graft failure. This review explores cardiac biomarkers for better donor heart assessment and transplantation outcomes.
Area of Science:
- Cardiology
- Transplantation Medicine
- Biomarker Research
Background:
- Donor heart supply is insufficient for demand, leading to patient mortality.
- Current donor heart assessment methods are inadequate, resulting in graft failure.
- Unused donor hearts may be declined due to concerns about poor function.
Purpose of the Study:
- To review the current status of biomarkers in assessing donor hearts for transplantation.
- To explore the potential of biomarkers in improving the selection of suitable donor hearts.
- To identify biomarkers that can predict early graft failure in recipients.
Main Methods:
- Literature review of existing studies on donor heart assessment.
- Analysis of the role of cardiac biomarkers in diagnosing and risk-stratifying cardiac conditions.
- Examination of specific biomarker categories including cardiac troponins, cytokines, inflammatory markers, natriuretic peptides, and intracellular proteins.
Main Results:
- Biomarkers are established tools for diagnosing and risk-stratifying myocardial infarction, acute coronary syndromes, and heart failure.
- Several biomarker categories show potential discriminant value for donor heart assessment.
- Current assessment methods for donor hearts are insufficient to predict post-transplant function.
Conclusions:
- Biomarkers offer a promising avenue to enhance donor heart selection accuracy.
- Improved donor heart assessment using biomarkers could increase transplantation rates and reduce graft failure.
- Further research into specific cardiac biomarkers is warranted to optimize donor heart utilization and recipient outcomes.
Abstract:
Demand for donor hearts exceeds supply, and a significant number of patients die while awaiting transplantation. Within the pool of currently unused potential donor hearts, a proportion may be suitable for transplantation but are declined due to anticipated poor function. Despite current assessment methods, in some donor hearts accepted for transplantation early graft failure develops in the recipient. Current methods of assessment are inadequate, and there is a potential for biomarkers to improve identification of satisfactory hearts for transplantation or hearts destined to fail in the recipient. Biomarkers are routinely used to diagnose and risk-stratify myocardial infarction, acute coronary syndromes, and heart failure. Some of these might facilitate donor heart assessment. Cardiac troponins, cytokines, inflammatory markers, natriuretic peptides, and intracellular proteins may each have discriminant value. This review details the current status of biomarkers in the assessment of donor hearts.
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