TROPONIN-T AS A MARKER FOR POSTTRANSPLANTATION ADAPTATIONAL PROBLEMS OF THE DONOR HEART

Background: Troponin T is used as a marker for myocardial cell damage (e.g., in aiding diagnosis and follow-up of myocardial infarction). El evated 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 orth otopic heart transplantation were tested for troponin T with a one-ste p enzyme immunoassay. The highest concentrations of troponin T were se en between day 3 and 14 after transplantation (3.05 +/- 1.30 mu g/L) a nd remained elevated up to 3 months. A correlation (r = 0.61, p < 0.02 ) was found between pretransplantation systolic pulmonary artery press ure and the cumulative troponin T release after transplantation. No as sociation was found with rejection, and no correlation was found with ischemic time of the donor heart. Conditions: These findings support t he hypothesis that the acute exposure of the donor heart to the preexi sting 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 monito ring and management of ventricular function after orthotopic heart tra nsplantation.