Abstract 13387: Prognostic Value of a Novel Circulating Serum Galectin-3 Binding Protein for the Development of a Transplant Vasculopathy After Heart Transplantation
Background_ Heart transplantation is a treatment for end stage heart failure. But several complications such as acute rejection, graft failure, transplant vasculopathy (TVP) and cancer still limits the survival after heart transplantation. Galectin-3 binding protein (Gal-3BP) (human s90K/Mac-2BP) seem to have pro- as well as anti-inflammatory effects in various immune diseases. Thus, we investigated whether Gal-3BP represents an adequate marker for fatal complications after heart transplantation.
Methods_ The study investigated the role of the immune modulator Gal-3BP by using an assay to determine the concentration of Galectin-3BP serum levels from 100 cardiac allograft recipients 6 weeks and then yearly up to five years after transplantation. Of each patient clinical data, medication and blood parameter were collected. TVP were diagnosed by coronary angiography.
Results_ The study demonstrated that patients developing a TVP within five years after transplantation had significantly higher Gal-3BP serum levels 6 weeks after transplantation compared to patients without a TVP (4006±2681ng/mL vs. 1963±979ng/mL, p<0.001). The difference of Gal-3BP serum levels between the groups persists of a five year follow up (all p<0.0001). Using the ROC analysis a serum Gal-3BP concentration of 2842 ng/mL was found to be the best cutoff to classify patients with a high risk to develop a TVP with a sensitivity of 91% and a specificity of 85% 6 weeks after transplantation. Even more importantly, by grouping the patients according to the cutoff we found an adverse outcome for patients with Gal-3BP serum levels above 2842 ng/mL compared to patients below it during a five year follow up (p<0.0001). The multivariate analysis demonstrated that Gal-3BP serum levels surgery emerged as an independent risk factor to predict fatal complications within a five year follow up (p=0.01).
Conclusions_ The results of our study clearly demonstrates that Gal-3BP represents a potent independent biomarker in order to predict the development of a TVP and an adverse outcome in cardiac allograft recipients after transplantation. Further studies are needed to elucidate the underlying pathomechanisms and to validate an algorithm for laboratory screening.
- © 2011 by American Heart Association, Inc.