Abstract 15668: Longitudinal Changes in High Sensitivity Troponin T and Pro-B-Type Natriuretic Peptide Over Two Post-Transplant Years in Rejection-Free Pediatric Heart Recipients
Purpose: High sensitivity troponin T (hs-TnT) and pro-B-type natriuretic peptide (pro-BNP) assays may be of value for rejection-surveillance in heart transplant (HT) recipients, a use that requires a better understanding of their behavior in rejection-free patients.
Hypothesis: The serum concentrations of hs-TnT, pro-BNP and four other biomarkers will be elevated early post-HT and decline over time in rejection-free pediatric HT recipients.
Methods: We measured serial biomarker concentrations in 24 children who received HT (median age at HT 6.6 yrs, range 0.5-16) at our institution between March 2013 and January 2014 and remained rejection-free by biopsy. All blood samples were prospectively collected at the time of biopsy. Patients with rejection (defined as ISHLT cellular Grade ≥2R or antibody mediated rejection) were excluded. Hs-TnT, pro-BNP, hs-CRP, ST2 (an interleukin 1 receptor inhibitor), galectin-3, and vascular endothelial growth factor (VEGF) were measured from frozen stored serum samples.
Results: We obtained 81 frozen serum samples (median 3 samples per patient, range 2- 7). There was a significant decline in hs-TnT, pro-BNP and hs-CRP levels within first 6 months after HT (all P ≤ 0.005) but not in ST2, Galectin-3 and VEGF levels. The serum concentrations of biomarker values in median (25th, 75th percentiles) by time since HT are shown in Figure 1. Higher hs-TnT and ST-2 concentrations were associated with younger donor age (r= -0.65, p= 0.06 and r= -0.66, p= 0.05) and longer ischemic time (r= 0.67, p= 0.05 and r= 0.75, p= 0.02).
Conclusion: In this prospective study, we found marked elevation of serum concentrations of hs-TnT, pro-BNP and hs-CRP early after HT. Levels declined over time in pediatric HT recipients who remained rejection-free. Adjusting for time since HT may improve the diagnostic utility of these biomarkers for non-rejection surveillance protocols.
Author Disclosures: F.I. Lunze: None. T.P. Singh: None. N. Rifai: None. K. Gauvreau: None. R. Narciso: None. K.P. Daly: None. L.B. Smoot: None. C. VanderPluym: None. E.D. Blume: None. S.D. Colan: None.
- © 2014 by American Heart Association, Inc.