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- Title
Plasma B-type natriuretic peptide levels in cardiac donors.
- Authors
Amir, Nezar L.; Gerber, Ivor L.; Edmond, John J.; Langlands, Janice M.; Richards, A. Mark; Ruygrok, Peter N.
- Abstract
Introduction: Elevated levels of plasma brain natriuretic peptide (BNP) and amino-terminal BNP (NT-proBNP) are associated with adverse cardiac outcomes. It is not known whether BNP and NT-proBNP levels in heart donors can aid in selection and predict outcomes in transplant recipients. Methods: Plasma BNP and NT-proBNP were measured in 32 organ donors prior to removal from life-support systems. Twelve hearts were accepted and 20 hearts were declined (no suitable recipient – 12, probable coronary artery disease – four, abnormal echocardiogram – three, other medical reasons – one). Records of heart transplant recipients were reviewed for: survival at 30 d, length of intensive care stay and need for intra-aortic balloon counter-pulsation (IABP). Results: Donors were divided into three groups – Group 1 (n = 12): accepted hearts; Group 2 (n = 12): acceptable hearts not transplanted for logistic reasons; Group 3 (n = 8): declined because of probable cardiac disease. BNP and NT-proBNP levels were significantly lower in donors with acceptable hearts (n = 24) compared with those with unacceptable hearts (n = 8) (p = 0.02 and 0.032, respectively). Of the 12 patients transplanted, four suffered a suboptimal outcome (two died, one required inotropic support and IABP, one prolonged hospitalization) while eight had good outcomes with no significant difference in BNP/NT-proBNP levels between these groups. Conclusion: BNP and NT-proBNP levels were lower in organ donors whose hearts were acceptable for transplantation compared with those whose hearts were unsuitable. Measuring natriuretic peptides may be a useful adjunctive tool in the selection of donor hearts. We feel that further studies are warranted.
- Subjects
ORGAN donation; TRANSPLANTATION of organs, tissues, etc.; ORGAN donors; HEART diseases; HEART transplantation; CRITICAL care medicine; CORONARY arteries; HEART blood-vessels
- Publication
Clinical Transplantation, 2009, Vol 23, Issue 2, p174
- ISSN
0902-0063
- Publication type
Article
- DOI
10.1111/j.1399-0012.2009.00954.x