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Gustav Smith

Associate professor

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Myocardial injury biomarkers at point of care for early identification of primary graft dysfunction after heart transplantation

Author

  • Victoria Jernryd
  • Carsten Metzsch
  • Bodil Andersson
  • J Gustav Smith
  • Johan Nilsson

Summary, in English

INTRODUCTION: Primary graft dysfunction (PGD) is a leading cause of 30-day mortality following heart transplantation, and early intervention in PGD may correlate to improved survival. Our analysis aimed to determine the feasibility of measuring cardiac biomarkers from the donor heart in the early phase for use as a predictor of PGD.

METHODS: Blood samples from the coronary sinus were obtained at the time of transplantation in hearts preserved by cold static storage. The samples were analyzed for CK-MB and cTnI with a point-of-care method. The primary outcome was severe PGD or the need for veno-arterial extracorporeal membrane oxygenation within 7 days, referred to as severe graft dysfunction.

RESULTS: Of the total cohort (n = 63), eight patients (13%) were diagnosed with severe graft dysfunction within 7 days. Patients with high CK-MB had an increased risk for severe graft dysfunction with unadjusted Odds Ratio (OR) of 4.5 (95%CI .96-21.11 P = .057) and adjusted OR of 7.4 (95%CI 1.13-48.46, P = .037. Similar but non significant trends were observed for cTnI.

CONCLUSION: By measuring CK-MB from the coronary effluent in the donor heart, it may be possible to identify patients at increased risk for severe PGD after heart transplantation.

Department/s

  • Artificial Intelligence in CardioThoracic Sciences (AICTS)
  • Thoracic Surgery
  • Cardiothoracic anesthesia and intensive care
  • Less invasive cardiac surgery
  • Anesthesiology and Intensive Care
  • LUCC: Lund University Cancer Centre
  • eSSENCE: The e-Science Collaboration
  • Hepato-Pancreato-Biliary Surgery
  • Surgery (Lund)
  • WCMM-Wallenberg Centre for Molecular Medicine
  • Heart Failure and Mechanical Support
  • Cardiovascular Epigenetics
  • Cardiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Molecular Epidemiology and Cardiology
  • Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)
  • Heart and Lung transplantation

Publishing year

2021-11-05

Language

English

Publication/Series

Clinical Transplantation

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Cardiac and Cardiovascular Systems

Status

Epub

Research group

  • Artificial Intelligence in CardioThoracic Sciences (AICTS)
  • Cardiothoracic anesthesia and intensive care
  • Less invasive cardiac surgery
  • Hepato-Pancreato-Biliary Surgery
  • Heart Failure and Mechanical Support
  • Cardiovascular Epigenetics
  • Molecular Epidemiology and Cardiology
  • Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)
  • Heart and Lung transplantation

ISBN/ISSN/Other

  • ISSN: 1399-0012