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Troponin T as a marker for posttransplantation adaptational problems of the donor heart
G Halwachs1, F Iberer, T Pieber
1Department of Internal Medicine, Karl Franzens University, Graz, Austria.
Background:
Troponin T is used as a marker for myocardial cell damage (e.g., in aiding diagnosis and follow-up of myocardial infarction). Elevated troponin T levels are also observed after heart transplantation, although until now no explanation could be found for this phenomenon.
Methods And Results:
Serum samples of 15 patients who underwent orthotopic heart transplantation were tested for troponin T with a one-step enzyme immunoassay. The highest concentrations of troponin T were seen between day 3 and 14 after transplantation (3.05 +/- 1.30 micrograms/L) and remained elevated up to 3 months. A correlation (r = 0.61, p < 0.02) was found between pretransplantation systolic pulmonary artery pressure and the cumulative troponin T release after transplantation. No association was found with rejection, and no correlation was found with ischemic time of the donor heart.
Conditions:
These findings support the hypothesis that the acute exposure of the donor heart to the preexisting elevated right ventricular afterload in the recipient represents a strong mechanical stress for the transplanted heart. Measurement of troponin T may therefore be helpful in the posttransplantation monitoring and management of ventricular function after orthotopic heart transplantation.