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Eur J Cardiothorac Surg 2002;22:233-237
© 2002 Elsevier Science NL

Troponin T and I are not reliable markers of cardiac transplant rejection

^a Division of Cardiac Surgery, The University of Alberta Hospital, 2D2.18 W.C. Mackenzie Health Sciences Centre, 8440-112 Street, Edmonton, Alta T6G 2B7, Canada
^b Transplant Services, The University of Alberta Hospital, CSB 1-198, 8440-112 Street, Edmonton, Alta T6G 2B7, Canada
^c Division of Cardiology, The University of Alberta Hospital, 2C2 W.C. Mackenzie Health Sciences Centre, 8440-112 Street, Edmonton, Alta T6G 2B7, Canada

Received 29 November 2001; received in revised form 29 April 2002; accepted 2 May 2002.

* Corresponding author. Tel.: +1-780-407-6327; fax: +1-780-407-6752
e-mail: jmullen{at}ualberta.ca

Objective: Heart transplant recipients undergo a number of invasive endomyocardial biopsies to screen for rejection. Serum assays of troponin T and/or I may provide a less invasive alternative. The purpose of this study was to evaluate troponin T and I as markers of cardiac transplant rejection. Methods: We conducted a prospective analysis comparing troponin T and I levels to biopsy results in heart transplant recipients. Plasma was assayed for troponin T and I preoperatively, on the first 3 postoperative days, and with each subsequent biopsy. Results: Twenty-nine patients entered the study. A total of 173 biopsies were performed at a mean follow-up of 129±9 days (range: 12–564 days). There were two rejection episodes (grade 3), one in each of two patients. There were no significant relationships between troponin T or I and biopsy-proven rejection (grade 3; P=0.59 and 0.54, respectively). There were also no correlations between troponin T or I levels and biopsy grade (P=0.40 and 0.92, respectively). Troponin T and I levels peaked on postoperative day 1 and fell to baseline over long-term follow-up with no peak in serum markers associated with rejection episodes. Donor ischemic time was significantly correlated to troponin T on postoperative days 1–3 (r=0.58, P=0.005; r=0.61, P=0.004; and r=0.61, P=0.003, respectively). Conclusions: Troponin T and I are not useful indicators of cardiac rejection, but do correlate with donor heart ischemic injury.

Key Words: Heart transplantation • Graft rejection • Troponin T • Troponin I