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Plasma B‐type natriuretic peptide levels in cardiac donors
Author(s) -
Amir Nezar L.,
Gerber Ivor L.,
Edmond John J.,
Langlands Janice M.,
Richards A. Mark,
Ruygrok Peter N.
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.00954.x
Subject(s) - medicine , natriuretic peptide , inotrope , cardiology , transplantation , heart transplantation , coronary artery disease , heart failure , brain natriuretic peptide , intra aortic balloon pump , intra aortic balloon pumping , myocardial infarction , cardiogenic shock
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.